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1.
The objective of our study was to determine individual and global glomerular filtration rates (GFRs) using dynamic renal computed tomography (CT) in Beagle dogs. Twenty-four healthy Beagle dogs were included in the experiment. Anesthesia was induced in all dogs by using propofol and isoflurane prior to CT examination. A single slice of the kidney was sequentially scanned after a bolus intravenous injection of contrast material (iohexol, 1 mL/kg, 300 mgI/mL). Time attenuation curves were created and contrast clearance per unit volume was calculated using a Patlak plot analysis. The CT-GFR was then determined based on the conversion of contrast clearance per unit volume to contrast clearance per body weight. At the renal hilum, CT-GFR values per unit renal volume (mL/min/mL) of the right and left kidneys were 0.69 ± 0.04 and 0.57 ± 0.05, respectively. No significant differences were found between the weight-adjusted CT-GFRs in either kidney at the same renal hilum (p = 0.747). The average global GFR was 4.21 ± 0.25 mL/min/kg and the whole kidney GFR was 33.43 ± 9.20 mL/min. CT-GFR techniques could be a practical way to separately measure GFR in each kidney for clinical and research purposes.  相似文献   

2.
Commonly used clinical indicators of renal disease are either insensitive to early dysfunction or have delayed results. Decreased glomerular filtration rate (GFR) indicates renal dysfunction before there is a loss of 50% of functional nephrons. Most tests evaluate global rather than individual kidney function. Dynamic computed tomography (CT) and Patlak plot analysis allows for individual GFR to be tested. Our objectives were to establish a procedure and provide reference values for determination of global GFR in 10 healthy cats using dynamic CT (CTGFR). This method of GFR determination was compared against serum iohexol clearance (SIC). A single CT slice centered on both kidneys and the aorta was acquired every fifth second during and after a bolus injection of iohexol (240 mgI/ml; 300 mgI/kg) for 115 s. Using data from this dynamic acquisition, Patlak plots were obtained, GFR was calculated, and results were compared to global GFR determined by iohexol clearance. The average global CTGFR estimate was 1.84 ml/min x kg (SD = 0.43; range = [1.22, 2.45]). The average global GFR measured using SIC was 2.45 ml/min x kg (SD = 0.58; range = [1.72, 3.69]). GFR measurements estimated by both dynamic CT and SIC were positively associated (estimated Spearman rank correlation coefficient = 0.72; P = 0.0234). The CTGFR method consistently underestimated GFR with a bias of -0.62 (SE = 0.1307) when compared to SIC (P = 0.0011). In healthy cats, CTGFR was capable of determining individual kidney function and appears clinically promising.  相似文献   

3.
The purpose of this project was to establish a procedure and reference values for glomerular filtration rate (GFR) using contrast-enhanced computed tomography (CT) in eight healthy dogs. A single section of the kidney was scanned sequentially after bolus injection (3 ml/s) of iohexol (300 mg/kg). Time-attenuation curves were constructed and the GFR per volume of kidney was calculated using Patlak graphical analysis software. The GFR was then converted from contrast clearance per unit volume (ml/min/ml) to contrast clearance per body weight (ml/min/kg). Individual kidney and global GFR were calculated using both CT and nuclear scintigraphy. Global GFR for each dog was also determined by plasma iohexol clearance. Contrast-enhanced CT underestimated the global GFR compared with the other two methods. The average global GFR was 2.57 +/- 0.33 ml/ min/kg using functional CT and 4.06 +/- 0.37 ml/min/kg using plasma iohexol clearance. There was significant (P < 0.05) interobserver variability of CT GFR of the right kidney and total GFR. There was decreased interobserver variability for the left kidney. There was no difference in the intraobserver variability for CT-determined individual kidney and global GFR. There was no difference between the motion corrected and nonmotion corrected values for individual and global CT GFR. Nuclear scintigraphy produced a slightly higher coefficient of variation than contrast-enhanced CT, 2.9% and 1.0%, respectively. It is hypothesized that altered renal blood flow, hematocrit of the small vessels, and nephrotoxicity play a role in the underestimation of GFR by contrast-enhanced CT.  相似文献   

4.
The suitability of 99mTc-diethylenetriaminepentaacetic acid (99mTc-DTPA) as an agent to assess glomerular filtration rate (GFR) in dogs was evaluated. Glomerular filtration rates of 12 healthy dogs were determined on the basis of creatinine and/or inulin clearance. Glomerular filtration rates also were determined in 7 dogs after induction of acute renal failure by administration of amphotericin B. The healthy dogs and the amphotericin B-treated dogs were given 99mTc-DTPA (1 to 2 mCi) IV. The percentage of the 99mTc-DTPA dose in the kidneys (percentage dose) was determined, with background activity subtracted from total activity at 15-s intervals 0 to 6 minutes after 99mTc-DTPA infusion. Linear regression analyses (LRA) were performed to determine whether the percentage dose at various time intervals after injection correlated with GFR calculated on the basis of creatinine and inulin clearance data. One to 3 minutes after 99mTc-DTPA administration appeared to be the best period for analysis of the data. The percentage dose of 99mTc-DTPA (corrected for kidney depth differences) was determined and LRA against GFR were performed. The percentage dose correlated better with inulin clearance (r = 0.94) than with endogenous creatinine clearance (r = 0.83). Only inulin clearance correlations improved with kidney depth correction. The LRA was used to derive an equation that could be used to calculate GFR on the basis of the percentage dose. The equation derived from inulin regression was: GFR (milliliter/minute/kilogram of body weight) = 0.194 (depth-corrected percentage dose)--0.37; the equation derived from the creatinine regression was: GFR (milliliter/minute/kilogram) = 0.171 (depth-corrected percentage dose)-0.15.(ABSTRACT TRUNCATED AT 250 WORDS)  相似文献   

5.
Glomerular filtration rate (GFR) was measured in 12 clinically normal horses, using the standard inulin clearance method, and values were compared with values for 2 methods, using a single rapid IV injection of 99mTc-labeled diethylenetriaminepentaacetic acid (99mTc-DTPA). The first 99mTc-DTPA method used a 2-compartment model to calculate GFR blood clearance of the tracer. The second method used sequential digital gamma camera images of the kidneys to determine fractional accumulation of the total dose of the tracer in the kidneys (percentage of injected dose, gamma camera) from 0 to 10 minutes after radionuclide administration. Linear correlation among the 3 methods was determined. Mean (+/- SD) GFR, using the inulin clearance method, was 154.67 +/- 42.28 ml/min/100 kg of body weight. Mean GFR, using the 2-compartment blood clearance curve, was 146.92 +/- 27.49 ml/min/100 kg. Mean GFR, using percentage of injected dose (gamma camera method) was 154.7 +/- 22.00 ml/min/100 kg. The percentage of injected dose (gamma camera method) did not correlate significantly to the inulin clearance results. However, a significant (r = 0.666, P less than 0.018) correlation was observed between the inulin method and the 99mTc-DTPA blood clearance method. Significant (P less than 0.0001) difference also was observed in the split function of the equine kidneys, with GFR of the right kidney contributing 60.1 +/- 9.12% of the total function, as determined by 99mTc-DTPA gamma camera imaging. Because the 99mTc-DTPA blood clearance method does not require urine collection, it may be a more practical procedure to measure GFR in the horse.  相似文献   

6.
OBJECTIVE: To evaluate accuracy of measuring plasma clearance of inulin as an alternative renal function test for estimation of glomerular filtration rate (GFR) in cats. ANIMALS: 10 cats, first studied with intact kidneys and subsequently studied following partial nephrectomy. PROCEDURE: Clearance studies were performed in 10 clinically normal cats; those same cats then underwent partial nephrectomy, and clearance studies were performed again. Plasma concentration of inulin was determined after administration at 50 mg/kg of body weight to cats while renally intact and 45 mg/kg after the partial nephrectomy. Plasma clearance of inulin (PCin) was determined by dividing the dose by the area under the plasma inulin concentration versus time curve. Results for PCin were compared with values obtained simultaneously for urinary clearance of exogenously administered creatinine (Ccr), a widely accepted method for measurement of GFR in cats with intact kidneys and cats with reduced renal mass. RESULTS: Results of PCin were strongly correlated (r2 = 0.912, P < 0.001) with Ccr. Repeatability of determination of PCin was similar to that of Ccr. Sensitivity and specificity of PCin were superior and equivalent to that of Ccr, respectively. CONCLUSIONS AND CLINICAL RELEVANCE: Determination of PCin provides a reliable estimate of GFR in cats and is a promising alternative to determining Ccr in cats.  相似文献   

7.
The scintigraphically measured percentage dose uptake of 99mTc-DTPA by the kidneys and the plasma clearance of 99mTc-DTPA have been reported to correlate well with inulin clearance. These two parameters were evaluated in seven dogs with known or suspected naturally occurring renal disease and compared to simultaneously measured renal inulin clearance. Correlation between inulin clearance and the 99mTc-DTPA plasma clearance was better ( p =.0016) than the correlation between the percentage DTPA uptake by the kidney. It was concluded that measurement of 99mTc-DTPA plasma clearance is a more accurate method to estimate global glomerular filtration rate (GFR) than the percentage kidney uptake.  相似文献   

8.
Glomerular filtration rate (GFR), an important parameter of renal function, is difficult to assess clinically. Serum creatinine and blood urea nitrogen measurements lack sensitivity, whereas radionuclide determination of GFR is not always available and requires postinjection patient isolation. GFR can be determined using computed tomography (CT), most commonly via Patlak plot analysis. Four adult cats, two adult dogs, and a foal underwent abdominal CT under general anesthesia for various diseases of the upper urinary tract. CT‐GFR was measured with a single‐slice dynamic acquisition and Patlak plot analysis. In five animals, the total CT‐GFR appeared to be below normal, corresponding with mild (two animals) and moderate (two animals) increases of serum creatinine in four. In the two animals with normal or increased CT‐GFR, serum creatinine was within the reference values. A significant negative logarithmic relationship was found between CT‐GFR and serum creatinine values (P=0.008; r2=0.75). No complications occurred during or following CT‐GFR. CT examination provided clinically relevant information in 3/5 patients with possible ureteral obstruction and in 3/3 patients with suspected ureteral calculi. Single‐slice dynamic CT‐GFR was practical and provided clinically useful information in this small series of patients undergoing CT of the upper urinary tract. There was a significant relationship between CT‐GFR and serum creatinine values, which supports the clinical potential of CT‐GFR and justifies further investigation of this technique.  相似文献   

9.
The nuclear imaging technique known as quantitative renal scintigraphy was validated as a means to assess the kidney function of cats. Renal function tests were performed in 6 healthy cats and 3 cats with clinical manifestations of kidney failure. In addition, the nephrotoxic drugs, gentamicin sulfate, or amphotericin B were used in an attempt to induce renal failure in 4 cats. Using linear regression analysis, equations were derived to estimate the glomerular filtration rate (GFR) on the basis of the renal percent uptake of 99mTc-diethylenetriaminepentaacetic acid (99mTc-DTPA). One-way ANOVA and Student's t test were used to evaluate treatment effects on clearances of inulin and creatinine, percent uptake of 99mTc-DTPA, and serum creatinine concentrations. The results show that the percent uptake of 99mTc-DTPA by the kidneys correlated well with the GFR obtained through the clearance of inulin. Thus, it was concluded that quantitative renal scintigraphy, using 99mTc-DTPA as a marker of kidney function, is an adequate technique to estimate the kidney function of healthy cats and cats with functional renal impairment. The best estimate of the GFR of cats, using the percentage dose of 99mTc-DTPA, was obtained on the 1- to 3-minute postinjection interval of the marker, using data that was background-subtracted, but not corrected for tissue absorption of gamma rays or binding of 99mTc-DTPA to plasma proteins. There was no significant difference in the mean inulin clearance, creatinine clearance, or percent uptake of 99mTc-DTPA between the 3 treatment groups of this study.(ABSTRACT TRUNCATED AT 250 WORDS)  相似文献   

10.
The goals of this study were to determine if the glomerular filtration rate (GFR) in dogs could be estimated by plasma inulin clearance and/or infusion inulin clearance analyses without urine collection, and to compare these results with GFR values obtained by urinary inulin clearance analysis. The dogs included in this study were healthy 20 beagles. Inulin clearance values were obtained by urinary inulin clearance, infusion inulin clearance, and plasma inulin clearance techniques. Urinary inulin clearance was 4.09±0.52 ml min(-1) kg(-1) (body weight); infusion inulin clearance, 4.01±0.49 ml min(-1) kg(-1); and plasma inulin clearance, 4.14±0.66 ml min(-1) kg(-1). The urinary inulin clearance was strongly correlated with infusion inulin clearance and weakly correlated with plasma inulin clearance. The GFR for dogs can be estimated by infusion and plasma inulin clearance analyses by blood sampling alone, without urine collection.  相似文献   

11.
Comparison of four methods of estimating glomerular filtration rate in cats   总被引：2，自引：0，他引：2  
Four methods of evaluating renal function were performed in 6 cats anesthetized with halothane in oxygen. Glomerular filtration rate (GFR) was measured simultaneously in each cat by exogenous creatinine clearance (ECC), bolus inulin clearance, and 99mTc(Sn)-diethylene-triaminepentaacetic acid (DTPA) clearance determined by 2 different methods. In the first DTPA clearance method (DTPA-1), we measured radioactivity in serial blood specimens to construct plasma disappearance curves for calculation of GFR. In the second DTPA clearance method (DTPA-2), we used serial external head counts of radioactivity and a single blood specimen to construct plasma disappearance curves for calculation of GFR. Bolus inulin clearance was calculated from plasma disappearance curves using a 1-compartment open pharmacokinetic model (IN-1) and a 2-compartment open pharmacokinetic model (IN-2). Glomerular filtration rates were measured over 3 hours, for creatinine and DTPA methods, and over 4 hours for the inulin methods. The GFR obtained with the reference method (ECC) was 2.56 +/- 0.61 ml/min/kg of body weight (mean +/- SD). Values for GFR determined by ECC and DTPA-1 were significantly correlated (r = 0.852; P less than or equal to 0.05). Correlation between ECC and DTPA 2 was not as good (r = 0.783; P less than or equal to 0.10), but the 2 DTPA methods significantly correlated with one another (r = 0.897; P less than or equal to 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)  相似文献   

12.
The effectiveness of technetium 99m-labeled diethylenetriaminepentaacetic acid (99mTc DTPA) to assess renal function in 13 dogs with suspected renal disease was evaluated. Glomerular filtration rates (actual GFR) were determined on the basis of endogenous creatinine clearance. Predicted GFR were determined by using 99mTc DTPA within 72 hours after the determination of creatinine clearance. The percentage of an IV administered dose of 99mTc DTPA in the kidneys (percentage dose) was determined. Two equations were used to calculate predicted GFR, which were derived from previously reported linear regression analysis of inulin (In) and creatinine (Cr) GFR vs percentage dose 99mTc DTPA in dog kidneys. The correlations of actual GFR vs predicted GFR (In) and actual GFR vs predicted GFR (Cr) were both r = 0.92. The dogs' mean actual GFR was 1.73 +/- 1.35 ml/min/kg. Their mean predicted GFR (In) and predicted GFR (Cr) were 1.92 +/- 1.42 ml/min/kg and 1.85 +/- 1.27 ml/min/kg, respectively. Therefore, 99mTc DTPA can be used with high accuracy as an agent to predict GFR in dogs with suspected renal disease. The procedure for determining GFR by use of nuclear medicine was rapid and noninvasive and appeared to induce little stress in the animals evaluated.  相似文献   

13.
The purpose of this study was to describe the ultrasonographic (US) and computed tomographic (CT) appearance of autosomal dominant polycystic kidney disease (ADPKD) in cats; to compare renal volume in cats with ADPKD (n = 5; mean age 59 +/- 10 months)) and normal cats (n = 5; mean age 66 +/- 10 months) using 2 imaging modalities, US and CT; and to calculate cyst volume using CT. Glomerular filtration rate (GFR) was determined by 2 methods: 99mTc-diethylene-triaminepentaacetic acid (99mTc-DPTA) scintigraphic uptake and 99-Tc-DTPA plasma clearance. Sonographically, ADPKD affected kidneys were characterized by multiple anechoic to hypoechoic, round to irregularly shaped structures with variation in size. Affected kidneys had indistinct corticomedullary junctions and foci of mineralization. Intravenous (IV) contrast medium administration allowed more definitive identification of cysts with CT, and identification of distortion of renal pelves by cysts. A significant difference (Welch ANOVA, P = 0.05) was detected between the US-estimated renal volumes of normal and affected cats. No statistically significant differences were detected in CT volume (between the normal and affected cats, or between US and CT volume measurements) or the 2 GFR methods. In this group of clinically normal, middle-aged ADPKD cats, renal function was within normal limits and not significantly different than normal.  相似文献   

14.
OBJECTIVE: To compare glomerular filtration rate (GFR) measured via urinary clearance of inulin (UCI) with plasma clearance of technetium Tc 99m pentetate (99mTc-pentetate) and creatinine in dogs. ANIMALS: 6 healthy Beagles and 18 Beagles with reduced renal function. PROCEDURE: 13 blood samples were obtained between 5 and 600 minutes after i.v. bolus injections of (99m)Tc-pentetate and creatinine. Plasma clearance of (99m)Tc-pentetate was computed on the basis of 1, 2, or 13 samples, and plasma clearance of creatinine was computed on the basis of 2, 5, or 13 samples. During plasma clearance procedures, constant i.v. infusion of carboxyl carbon 14 inulin was begun and UCI was determined in urine collected from 90 to 120, 120 to 180, and 180 to 240 minutes. Clearance procedures were repeated in 12 dogs to evaluate reproducibility of results. RESULTS: Significant association between UCI and plasma clearance was determined via all methods. However, plasma clearances were moderately to markedly different from UCI, depending on test substance, GFR, and sample numbers used for plasma clearance computations. Comparisons were particularly discordant when some methods of limiting samples were used to define plasma clearance. CONCLUSIONS AND CLINICAL RELEVANCE: Values derived from plasma clearance methods for (99m)Tc-pentetate and creatinine were not interchangeable with UCI results, which raises questions about their reliability as clinical research tools for measurement of GFR. Plasma clearance methods that are relative indices of renal function should not be interpreted as accurate measures of GFR without validation.  相似文献   

15.
OBJECTIVE: To determine whether bisection or intersegmental nephrotomy adversely affects glomerular filtration rate (GFR) and whether bisection nephrotomy has less adverse effect than intersegmental nephrotomy. STUDY DESIGN: Dogs assigned to 5 groups of 3 dogs each, depending on time of euthanasia at postoperative day 1, 4, 8, 15, or 29. ANIMALS: Fifteen healthy adult intact female dogs. METHODS: Within 4 days of total and single kidney GFR measurements using technetium Tc 99m-DTPA, left intersegmental nephrotomy and right bisection nephrotomy were performed. The GFR measurements were repeated the day before dogs were killed except for the day 1 group. Histologic examination was performed on kidneys harvested from day 1, 4, 8, and 29 groups. Severity of lesions was scored on a 0 to 4 scale. Single kidney GFR was compared in each kidney before and after nephrotomy. Histologic and GFR changes were compared between bisection and intersegmental nephrotomy kidneys for each time period. RESULTS AND CONCLUSIONS: Three days after surgery, total GFR was increased from baseline by 176%, with no difference in percent change in single kidney GFR between intersegmental and bisection nephrotomy. By day 7, total and single kidney GFR were not different than baseline. Bisection nephrotomy caused more intrarenal hemorrhage and cortical infarction and inflammation than intersegmental nephrotomy. By 4 weeks, no significant histologic differences were observed between the 2 techniques. CLINICAL RELEVANCE: Neither intersegmental nor bisection nephrotomy adversely affected GFR. As intersegmental nephrotomy requires additional surgical manipulation and time, bisection nephrotomy is the technique of choice for nephrotomy in dogs.  相似文献   

16.
Glomerular filtration rate (GFR) was determined in 53 cats using an inulin single-injection method. Thirty healthy young adult cats were used to establish normal values. The procedure was also used in 23 cats that were either older than 10 years or had borderline serum creatinine levels. The total clearance was calculated from the decay of the serum inulin concentration after injection of 3000 mg/m(2)body surface area using a two-compartment model. Concomitant inulin and iohexol clearance in nine cats showed excellent correlation between the two methods. Calculated normal values for GFR in 30 healthy cats were 35.9-58.5 (median 46.0) ml/min/m(2)or 2.07-3.69 (median 2.72) ml/min/kg. A few cats with normal creatinine or blood urea nitrogen levels were detected as having reduced GFR and therefore being in a state of early renal dysfunction. The study indicates that single-injection inulin clearance is a valuable tool for routine GFR measurement in cats. An "inulin excretion test" using only one blood sample 3h after the administration of 3000 mg/m(2)body surface area could prove an attractive alternative for the assessment of renal function in daily practice.  相似文献   

17.
OBJECTIVES: To determine effects of commonly used diuretic treatments on glomerular filtration rate (GFR), renal blood flow (RBF), and urine output (UO) and compare 2 methods of GFR measurement in healthy awake cats. ANIMALS: 8 healthy cats. PROCEDURE: In a randomized crossover design, cats were randomly allocated to 4 groups: control; IV administration of fluids; IV administration of fluids and mannitol; and IV administration of fluids, dopamine, and furosemide. Inulin and para-aminohippuric acid were used for determination of plasma clearance for GFR and RBF, respectively. Plasma clearance of technetium-Tc-99m-diethylenetriaminepentacetic acid (99mTc-DTPA) was also used for GFR determination. RESULTS: Furosemide-dopamine induced the largest UO, compared with other groups. Both mannitol and fluid therapy increased RBF, compared with the control group. Mannitol, and not fluid therapy, increased RBF, compared with furosemide-dopamine. There were significant differences in GFR values calculated from 99mTc-DTPA and inulin clearances between the 2 groups. In all groups, use of 99mTc-DTPA caused underestimation of GFR, compared with use of inulin. CONCLUSIONS AND CLINICAL RELEVANCE: In healthy awake cats, administration of furosemide-dopamine did not increase GFR or RBF despite increased UO. Fluid therapy and fluid therapy plus mannitol improved RBF. Determination of GFR by use of 99mTc-DTPA cannot always be substituted for inulin clearance when accurate measurement is required.  相似文献   

18.
Glomerular filtration rate (GFR), renal plasma flow (RPF), and the endogenous creatinine clearance (CCr) rate were determined in 13 captive cheetahs, Acinonyx jubatus jubatus (seven females and six males, 1.5-7.5 yr of age, x = 5.02 yr), during general anesthesia with Telazol and isoflurane by measuring the urinary clearances of inulin, para-aminohipppuric acid, and endogenous creatinine, respectively. Methods to determine GFR, RPF, and endogenous CCr in captive cheetahs were evaluated, and the relationship between GFR and CCr for this species was determined. The GFR and the RPF were stable during the procedure, with mean values of 1.59+/-0.17 ml/min/kg body weight and 5.12+/-1.15 ml/min/kg body weight, respectively. Although the mean value for CCr (1.47+/-0.20 ml/min/kg body weight) was significantly less than the corresponding value for GFR, the mean difference (0.11+/-0.02 ml/min/kg weight) between the two measurements was slight, and the values were highly correlated (R2 = 0.928; P < 0.0001). The measurement of CCr in cheetahs should provide a reliable estimate of GFR, facilitating the early detection of renal disease in this species.  相似文献   

19.
The aims of this study were to determine the total volume of the horse kidney and volume fractions of its functional subcomponents (cortex, medulla, renal pelvis) using stereological methods and investigate any possible difference in the functional subcomponents of the right and left kidneys that may arise from differences in shape. The study was carried out on the kidneys of 5 horses of different breed and sex. The weight of the kidneys was measured by a digital scale, and kidney volume was calculated by Archimedes' principle. Total kidney volume and volume fractions of subcomponents of the right and left kidneys were estimated by the Cavalieri's principle. The weights of the right and left kidneys were 550 ± 25 g and 585 ± 23 g, respectively. The volumes of the right and left kidneys estimated using the Cavalieri method were 542 ± 46 ml and 581 ± 29 ml. The relative organ weight of the kidneys was calculated as 1:330. The densities of the right and left kidneys were determined to be 1.01 and 1.00, respectively. The mean volume fractions of the cortex, medulla and renal pelvis were determined as 55.6, 42.7 and 1.7 in both kidneys. No statistically significant difference existed between morphometric data pertaining to the right and left kidneys (P > 0.05). To determine precisely whether differences in shape cause any difference in the functional subcomponents of the right and left kidneys requires further investigation of differences in the number of microscopically functional unit of the kidney such as renal glomeruli and nephrons.  相似文献   

20.
A 12-year-old, 6 kg, castrated male Siamese-cross cat was referred for investigation of an abdominal mass. The cat was found to have a left perinephric pseudocyst (PNP), accompanied by azotemia, with a small right kidney detected on ultrasound. Glomerular filtration rate (GFR) was determined by renal scintigraphy and was found to be low, with the left kidney contributing 64% of the total GFR. Percutaneous ultrasound-guided drainage of the PNP did not improve the GFR, and fluid reaccumulated within a short period of time. Laparoscopic fenestration of the cyst capsule was performed to allow for permanent drainage. The PNP did not recur, renal values progressively improved, and 8 months after the capsulotomy the GFR of the left kidney had increased by 50%, while renal function remained static on the right side.  相似文献   

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