The Radiorenocystogram in Chronic Pyelonephritis

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Abstract
Studies of normals and 35 patients with pyelonephritis led to the conclusion that the Hippuran-I131 renocystogram is a useful tool in the diagnosis and management of chronic pyelonephritis. Renocystogram abnormalities associated with this disease are: reductions in the slopes of the tubular segments, delayed onset of excretion, and excretion segments with descending slopes which are disproportionately shallow in relation to their corresponding tubular counterparts. These findings are at present interpreted to indicate impaired blood supply and/or tubular cell function, and interference with urine excretion. One or more of these abnormalities are characteristically more pronounced on one side than on the other in chronic pyelonephritis. Differences between right and left renal tracings are consistently accentuated in the renocystogram if fluids are restricted eight to twelve hours before the test, whereas they are usually reduced and occasionally obliterated if fluids are purposely given, as has been the custom in the past. Abnormalities of the renocystogram in chronic pyelonephritis often are corrected temporarily but rarely abolished permanently by appropriate therapy. In the future, serial renocystograms may help to improve the medical and surgical management of this insidious disease by directing attention to the correct diagnosis during asymptomatic stages and by indicating the effectiveness of therapeutic measures.