Objective: The main objective of the present study is to assess the interrelationship between renal calculi, selected ions, thyroid and parathyroid hormones and urinary tract infections. Methods: This study was carrie...Objective: The main objective of the present study is to assess the interrelationship between renal calculi, selected ions, thyroid and parathyroid hormones and urinary tract infections. Methods: This study was carried out on 150 patients attended Tikrit Teaching Hospital from 2008 to 2009. Stones and serum ions were analyzed utilizing relevant Biolab Company kits (France). Thyroid hormones were determined using ELISA microwells kit (Accuubind, USA) Parathyroid hormone was estimated by active I-PTH ELISA (DSL, USA).Urine cultures were done utilizing cystine-lactose- electrolyte deficient (CLED) medium. Various isolated pathogens were conventionally identified. Results: Urine cultures revealed that 42% of the patients had urinary tract infections particularly with Enterobacteriaceae. 68% of the stones tested were calcium oxalate. Infective and noninfective stones were classified. Calcium ion was more elevated in patients examined. Hypothyroidism was prevalent but parathyroid hormone (PTH) was elevated among 14 patients only. Conclusions: The frequency of UTI was higher among urolithiasis patients and the common causative agents were Gram negative bacteria. Renal stones of calcium origin were predominant. Hormonal abnormalities were seen. 15 patients with hyperthyroidism revealed hypercalcemia and hypercalciuria.展开更多
Purpose: The evaluation of lower urinary tract (LUT) before transplantation is not required, except in patients with a history of LUT disfunction (LUTD). In this study, we adressed the necessity for lower urinary syst...Purpose: The evaluation of lower urinary tract (LUT) before transplantation is not required, except in patients with a history of LUT disfunction (LUTD). In this study, we adressed the necessity for lower urinary system evaluation in transplantation candidates classified according to their etiology. Materials and Methods: Sixty-two patients were prospectively evaluated. The patients were evaluated at 2 months preoperatively and at 6 months post transplantation using questionnaires, bladder diary and urodynamic studies. The end stage renal disease (ESRD) etiologies of the patients were divided into three groups as follows: patients with a parenchymal disease, patients with LUTD and those with unknown etiology and the obtained results were evaluated accordingly. Results: The evaluation of 50 patients revealed significant differences in ICIQ-SF (p < 0.001), IPSS (p < 0.001), daily urine volumes (p = 0.05), maximum urinary flow rate (p = 0.03), PVR, the number of patients with VUR and all cystometric parameters between the patient groups divided according to the etiology. The comparison of the groups to each other revealed no statistically significant differences in all parameters between the LUTD group and the patient groups with unknown etiology. Considering that the results from questionnaires of patients with a single voided volume of 100 cc or greater on the bladder diary would be scientifically more significant, they were evaluated separately. Thus, even though the results from questionnaires did not differ between the group with unknown etiology and the LUTD group, there were significant differences when compared to patients who developed ESRD due to a parenchymal disease. Similar findings were found between the results of urodynamic study. Conclusions: The evaluation of lower urinary tract in patients with a history of LUTD and in those with unknown etiology should be initially evaluated by noninvasive methods such as questionnaires and uroflowmetry.展开更多
Nuclide renal dynamic imaging was performed on 88 transplanted kidney. Two kinds of renal scintigraphic characteristics were identified in recipients with supravesical obstruction of the graft. First, the regular typ...Nuclide renal dynamic imaging was performed on 88 transplanted kidney. Two kinds of renal scintigraphic characteristics were identified in recipients with supravesical obstruction of the graft. First, the regular type was characterized by radioactivity defect area in kidney parenchyma during early uptake period followed by ureteropelvic retention. Second, the tubular type was typified by cortical retention and attenuation in collecting system during the whole test period with a special sign of “hollow kidney”. Non obstructive dilated calyces showed similar signs as the regular type. Acute rejection reaction and tubule necrosis demonstrated obstructive time activity curves. However, the radioactivity retention appeared in cortex. It was suggested that dilated calyces and obstructive renogram might not be reliable evidence for upper urinary tract obstruction. The signs of radioactivity attenuation in kidney parenchyma during early uptake period followed by ureteropelvic retention may be more valuable for the evaluation. As for tubular obstruction, specified “hollow kidney” was the characteristic sign which is helpful for the diagnosis.展开更多
Over the past several years,advances in the technical domain of computed tomography(CT) have influenced the trend of imaging modalities used in the clinical evaluation of the urinary system.Renal collecting systems ca...Over the past several years,advances in the technical domain of computed tomography(CT) have influenced the trend of imaging modalities used in the clinical evaluation of the urinary system.Renal collecting systems can be illustrated more precisely with the advent of multi-detector row CT through thinner slices,high speed acquisitions,and enhanced longitudinal spatial resolution resulting in improved reformatted coronal images.On the other hand,a significant increase in exposure to ionizing radiation,especially in the radiosensitive organs,such as the gonads,is a concern with the increased utilization of urinary tract CT.In this article,we discuss the strategies and techniques availablefor reducing radiation dose for a variety of urinary tractCT protocols with metabolic clinical examples.We also reviewed CT for hematuria evaluation and related scan parameter optimization such as,reducing the number of acquisition phases,CT angiography of renal donors and lowering tube potential,when possible.展开更多
Congenital abnormalities of the kidney and urinary tract(CAKUT) include a wide range of abnormalities ranging from asymptomatic ectopic kidneys to life threatening renal agenesis(bilateral). Many of them are detected ...Congenital abnormalities of the kidney and urinary tract(CAKUT) include a wide range of abnormalities ranging from asymptomatic ectopic kidneys to life threatening renal agenesis(bilateral). Many of them are detected in the antenatal or immediate postnatal with a significant proportion identified in the adult population with varying degree of severity. CAKUT can be classified on embryological basis in to abnormalities in the renal parenchymal development, aberrant embryonic migration and abnormalities of the collecting system. Renal parenchymal abnormalities include multi cystic dysplastic kidneys, renal hypoplasia, number(agenesis or supernumerary), shape and cystic renal diseases. Aberrant embryonic migration encompasses abnormal location and fusion anomalies. Collecting system abnormalities include duplex kidneys and Pelvi ureteric junction obstruction. Ultrasonography(US) is typically the first imaging performed as it is easily available, noninvasive and radiation free used both antenatally and postnatally. Computed tomography(CT) and magnetic resonance imaging(MRI) are useful to confirm the ultrasound detected abnormality, detection of complex malformations, demonstration of collecting system and vascular anatomy and more importantly for early detection of complications like renal calculi, infection and malignancies. As CAKUT are one of the leading causes of end stage renal disease, it is important for the radiologists to be familiar with the varying imaging appearances of CAKUT on US, CT and MRI, thereby helping in prompt diagnosis and optimal management.展开更多
文摘Objective: The main objective of the present study is to assess the interrelationship between renal calculi, selected ions, thyroid and parathyroid hormones and urinary tract infections. Methods: This study was carried out on 150 patients attended Tikrit Teaching Hospital from 2008 to 2009. Stones and serum ions were analyzed utilizing relevant Biolab Company kits (France). Thyroid hormones were determined using ELISA microwells kit (Accuubind, USA) Parathyroid hormone was estimated by active I-PTH ELISA (DSL, USA).Urine cultures were done utilizing cystine-lactose- electrolyte deficient (CLED) medium. Various isolated pathogens were conventionally identified. Results: Urine cultures revealed that 42% of the patients had urinary tract infections particularly with Enterobacteriaceae. 68% of the stones tested were calcium oxalate. Infective and noninfective stones were classified. Calcium ion was more elevated in patients examined. Hypothyroidism was prevalent but parathyroid hormone (PTH) was elevated among 14 patients only. Conclusions: The frequency of UTI was higher among urolithiasis patients and the common causative agents were Gram negative bacteria. Renal stones of calcium origin were predominant. Hormonal abnormalities were seen. 15 patients with hyperthyroidism revealed hypercalcemia and hypercalciuria.
文摘Purpose: The evaluation of lower urinary tract (LUT) before transplantation is not required, except in patients with a history of LUT disfunction (LUTD). In this study, we adressed the necessity for lower urinary system evaluation in transplantation candidates classified according to their etiology. Materials and Methods: Sixty-two patients were prospectively evaluated. The patients were evaluated at 2 months preoperatively and at 6 months post transplantation using questionnaires, bladder diary and urodynamic studies. The end stage renal disease (ESRD) etiologies of the patients were divided into three groups as follows: patients with a parenchymal disease, patients with LUTD and those with unknown etiology and the obtained results were evaluated accordingly. Results: The evaluation of 50 patients revealed significant differences in ICIQ-SF (p < 0.001), IPSS (p < 0.001), daily urine volumes (p = 0.05), maximum urinary flow rate (p = 0.03), PVR, the number of patients with VUR and all cystometric parameters between the patient groups divided according to the etiology. The comparison of the groups to each other revealed no statistically significant differences in all parameters between the LUTD group and the patient groups with unknown etiology. Considering that the results from questionnaires of patients with a single voided volume of 100 cc or greater on the bladder diary would be scientifically more significant, they were evaluated separately. Thus, even though the results from questionnaires did not differ between the group with unknown etiology and the LUTD group, there were significant differences when compared to patients who developed ESRD due to a parenchymal disease. Similar findings were found between the results of urodynamic study. Conclusions: The evaluation of lower urinary tract in patients with a history of LUTD and in those with unknown etiology should be initially evaluated by noninvasive methods such as questionnaires and uroflowmetry.
文摘Nuclide renal dynamic imaging was performed on 88 transplanted kidney. Two kinds of renal scintigraphic characteristics were identified in recipients with supravesical obstruction of the graft. First, the regular type was characterized by radioactivity defect area in kidney parenchyma during early uptake period followed by ureteropelvic retention. Second, the tubular type was typified by cortical retention and attenuation in collecting system during the whole test period with a special sign of “hollow kidney”. Non obstructive dilated calyces showed similar signs as the regular type. Acute rejection reaction and tubule necrosis demonstrated obstructive time activity curves. However, the radioactivity retention appeared in cortex. It was suggested that dilated calyces and obstructive renogram might not be reliable evidence for upper urinary tract obstruction. The signs of radioactivity attenuation in kidney parenchyma during early uptake period followed by ureteropelvic retention may be more valuable for the evaluation. As for tubular obstruction, specified “hollow kidney” was the characteristic sign which is helpful for the diagnosis.
文摘Over the past several years,advances in the technical domain of computed tomography(CT) have influenced the trend of imaging modalities used in the clinical evaluation of the urinary system.Renal collecting systems can be illustrated more precisely with the advent of multi-detector row CT through thinner slices,high speed acquisitions,and enhanced longitudinal spatial resolution resulting in improved reformatted coronal images.On the other hand,a significant increase in exposure to ionizing radiation,especially in the radiosensitive organs,such as the gonads,is a concern with the increased utilization of urinary tract CT.In this article,we discuss the strategies and techniques availablefor reducing radiation dose for a variety of urinary tractCT protocols with metabolic clinical examples.We also reviewed CT for hematuria evaluation and related scan parameter optimization such as,reducing the number of acquisition phases,CT angiography of renal donors and lowering tube potential,when possible.
文摘Congenital abnormalities of the kidney and urinary tract(CAKUT) include a wide range of abnormalities ranging from asymptomatic ectopic kidneys to life threatening renal agenesis(bilateral). Many of them are detected in the antenatal or immediate postnatal with a significant proportion identified in the adult population with varying degree of severity. CAKUT can be classified on embryological basis in to abnormalities in the renal parenchymal development, aberrant embryonic migration and abnormalities of the collecting system. Renal parenchymal abnormalities include multi cystic dysplastic kidneys, renal hypoplasia, number(agenesis or supernumerary), shape and cystic renal diseases. Aberrant embryonic migration encompasses abnormal location and fusion anomalies. Collecting system abnormalities include duplex kidneys and Pelvi ureteric junction obstruction. Ultrasonography(US) is typically the first imaging performed as it is easily available, noninvasive and radiation free used both antenatally and postnatally. Computed tomography(CT) and magnetic resonance imaging(MRI) are useful to confirm the ultrasound detected abnormality, detection of complex malformations, demonstration of collecting system and vascular anatomy and more importantly for early detection of complications like renal calculi, infection and malignancies. As CAKUT are one of the leading causes of end stage renal disease, it is important for the radiologists to be familiar with the varying imaging appearances of CAKUT on US, CT and MRI, thereby helping in prompt diagnosis and optimal management.
