Arterial embolization in patients with grade-4 blunt renal trauma: evaluation of the glomerular filtration rates by dynamic scintigraphy with 99mTechnetium-diethylene triamine pentacetic acid

• Published in: Scandinavian journal of trauma, resuscitation and emergency medicine Vol. 18; no. 1; p. 11
• Main Authors: Morita, Seiji, Inokuchi, Sadaki, Tsuji, Tomoatsu, Fukushima, Tomokazu, Higami, Shigeo, Yamagiwa, Takeshi, Shinichi, Iizuka
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 07.03.2010; Springer Nature B.V; BioMed Central; BMC
• Subjects: Adolescent; Adult; Analysis; Care and treatment; Creatinine; Diabetes; Embolization; Embolization, Therapeutic - methods; Female; Glomerular filtration rate; Glomerular Filtration Rate - physiology; Head injuries; Health aspects; Hemodynamics; Humans; Isotopes; Kidney - diagnostic imaging; Kidney - injuries; Kidney - physiopathology; Kidney diseases; Kidneys; Male; Medical imaging; Middle Aged; Original Research; Patients; Radioisotope scanning; Radionuclide Imaging; Radiopharmaceuticals; Scintigraphy; Sports injuries; Technetium; Technetium Tc 99m Pentetate; Therapeutic embolization; Trauma; Violence; Wounds, Nonpenetrating - diagnostic imaging; Wounds, Nonpenetrating - physiopathology; Wounds, Nonpenetrating - therapy; Young Adult; Scandinavia
• ISSN: 1757-7241; 1757-7241
• DOI: 10.1186/1757-7241-18-11

High-grade blunt renal trauma has been treated by arterial embolization (AE). However, it is unknown whether AE preserves renal function, because conventional renal function tests reflect total renal function and not the function of the injured kidney alone. Dynamic scintigraphy can assess differential renal function. We performed AE in 17 patients with grade-4 blunt renal trauma and determined their serum creatinine (sCr) level and glomerular filtration rate (GFR; estimated by dynamic scintigraphy) after 3 months. In 4 patients with low GFR of the injured kidney (<20 ml.min-1.1.73 m-2), the GFR and sCr were measured again at 6 months. Data are presented as median and interquartile range (25th, 75th percentile). The median GFR of the injured kidney, total GFR, and median sCr at 3 months were 29.3 (23.7, 35.3) and 96.8 (79.1, 102.6) ml.min-1.1.73 m-2 and 0.6 (0.5, 0.7) mg/dl, respectively. In the patients with low GFR (ml.min-1.1.73 m-2), the median GFR of the injured kidney, total GFR, and median sCr (mg/dl) were 16.2 (15.7, 16.3), 68.7 (61.1, 71.6), and 0.7 (0.7, 0.9), respectively, at 3 months and 34.5 (29.2, 37.0), 90.9 (79.1, 98.8), and 0.7 (0.7, 0.8), respectively, at 6 months. The function of the injured kidney was preserved in all patients, indicating the efficacy of AE for the treatment of grade-4 blunt renal trauma.