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Urology  (Expert Forum)
 | 
MAG 3 Renal Scan with Lasix
Answered by
Kevin Pho, MD - Internal Medicine
Kevin, M.D. Boston - MA
Questions in the Urology forum are answered by Dr. Stephen Liroff, affiliated with the Henry Ford Hospital. Topics covered include benign prostate disease, penis curvature, cystisis, kidney stones, pediatric urology, prostate, sexual dysfunction, urinary tract infections (UTI), and urological cancers.

MAG 3 Renal Scan with Lasix

by bmfk, Aug 28, 2006 12:00AM
In July a abdominal CT scan showed marked left hydronephrosis and a 7-8mm stone in the left ureter along with bilateral stones.  Also small retroperitoneal nodes were seen.  A follow-up ultrasound by the urologist showed a possible congenital UPJ obstruction and I was sent for the renal scan.  I am a 42 year old female with no pain.  Urine tests revealed an UTI and microscopic blood.  The renal scan came back today with The blood flow to thr left kidney is moderately decreased nd the cortex is quite thin.  Activity transits slowly on the left but does transit to the bladder and no obviosu evidence of obstruction.  The function peak and excretory phase of the left kidney is flattened consistent with a decreased perfusion and function.  



Perfusion, function and drainage of the right kidney is normal.  The left kidney shows moderately decreased function and perfusion.  The drainage pattern of the left kidney is more probably due to decreased function rather than obstructive uropathy.  The left kidney contributes 22% to total function and the right 78%.



So what does all this mean?  Do I have the congenital UPJ obstruction?  The report seems like it says no obstruction.  So what would cause the decreased perfusion and function?  What is the significance of the cortex being quite thin?  Is 22% function bad?  Any possibility the kidney will resume normal function?  Will it ever have to be removed?



Thanks for your help.  I know you cannot treat online but any guidance or explanation would be greatly appreciated.

by Kevin Pho, MD, Aug 29, 2006 12:00AM
Difficult to say without examination.



Various types of intrinsic renal disease can lead to decreased function in the absence of obstruction.  



Imaging the kidneys with an ultrasound or CT scan may be helpful.  If non-revealing, a referral to a nephrologist can be considered to look for intrinsic kidney disease.  Obtaining a kidney biopsy can be considered.  



Without knowing the cause of the decreased function, it is difficult to predict whether the kidney would resume normal function.



These options can be discussed with your personal physician.



Followup with your personal physician is essential.



This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.



Kevin, M.D.

kevinmd_
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