Requena M J, Llamas J M, Prieto R, González F M, Regueiro J C, Vidal E, Molina J, Jiménez-Heffernán A, López Ruiz J M, Ruiz García J
Servicio de Medicina Nuclear, Hospital Virgen de las Nieves, Granada.
Actas Urol Esp. 1993 Jan;17(1):57-61.
Study of group of 61 patients, nephrectomized as a result of various diseases and who before and three months after surgery underwent blood pressure, effective renal plasma flow (EPFF) and unilateral renal function determinations in order to verify the compensating ability of the remaining kidney. Effective renal plasma flow was determined by a single injection and removal of six serial blood samples with 125-I-Hippuran. Unilateral renal function was determined from the relative uptake of 99mTc-DMSA 24 hours after injection. The patients were divided into four groups according to their overall and unilateral renal function as well as the presence or absence of hypertension. Patients with normal EPFF and symmetrical renal function showed a significantly increase in the function of the remaining kidney after surgery (p < 0.001). Patients with normal or slightly reduced EPFF (< 10%) and highly asymmetrical unilateral function as well as those with decreased EPFF (> 10%) and symmetrical or asymmetrical unilateral renal function did not increased the function of the remaining kidney after nephrectomy, and hypertensive patients whose blood pressure returned to normal values after nephrectomy had a decreased function of the remaining kidney after surgery (< 0.001). It is concluded that it is possible to predict the functional behaviour of the remaining kidney after nephrectomy, and that the compensating ability will basically depend on the previously existing (overall and unilateral) renal function as well as the presence or absence of hypertension.
对61例因各种疾病而接受肾切除术的患者进行研究，这些患者在手术前及术后三个月接受了血压、有效肾血浆流量（EPFF）和单侧肾功能测定，以验证剩余肾脏的代偿能力。有效肾血浆流量通过单次注射并采集六份连续血样（使用125-I-马尿酸）来测定。单侧肾功能在注射99mTc-二巯基丁二酸24小时后通过相对摄取量来确定。根据患者的总体和单侧肾功能以及是否存在高血压，将患者分为四组。有效肾血浆流量正常且肾功能对称的患者术后剩余肾脏功能显著增加（p < 0.001）。有效肾血浆流量正常或轻度降低（< 10%）且单侧功能高度不对称的患者，以及有效肾血浆流量降低（> 10%）且单侧肾功能对称或不对称的患者，肾切除术后剩余肾脏功能并未增加，而肾切除术后血压恢复正常的高血压患者术后剩余肾脏功能降低（< 0.001）。得出的结论是，有可能预测肾切除术后剩余肾脏的功能表现，并且代偿能力基本上将取决于先前存在的（总体和单侧）肾功能以及是否存在高血压。
