Diuretic Renal Imaging
PATIENT PREP
OFF ACE INHIBITORS FOR 1 WEEK
WELL HYDRATED
OFF ANY DIURETICS
CONTRAINDICATIONS
RENAL ARTERIOGRAM USING IV
IODINATED CONTRAST
MEDICATIONS THAT BLOCK
TUBULAR SECRETION
INDICATIONS
DISTINGUISH BETWEEN OBSTRUCTIVE
HYDRONEPHROSIS AND NON-OBSTUCTIVE
COLLECTING SYSTEM DIALATION
EVALUTION OF RENAL FUNCTION AND
URODYNAMICS
RADIOPHARMACEUTICALS
TC99m-MAG3 (10-20 mCi)
TC99m-DTPA (10-20 mCi)
INTERPRETATION
FINAL IMAGES
VISUAL UPTAKE
RENOGRAM
SHOWS TIME
ACTIVITY CURVE
FUROSEMIDE (LASIX)
40 mg FOR ADULTS
1 mg/kg FOR CHILDREN
USUALLY ADMINISTERED 15-20 MIN
AFTER RPH INJECTION OR WHEN
PELVIS IS DIALTED
IMAGING
STARTS IMMEDIATELY, 2 MIN
FLOW FOLLOWED BY
18 MIN OF DYNAMICS (USUALLY)
POSTERIOR
IMAGE FOR AN ADDITIONAL 20
MIN AFTER FUROSEMIDE INJ.
NORMAL RESULTS
CLEARANCE HALF TIME OF 8-12 MIN
THUS SHOWING NORMAL RENOGRAM
HOMOGENEOUS UPTAKE
BOTH KIDNEYS VISUAL
ABNORMAL RESULTS
CLEARANCE HALF TIME OF
<8 MIN OR >12 MIN
ONE OR NO KIDNEY VISUAL
HETEROGENEOUS UPTAKE