Isotope renography and long-term follow-up of renal transplant patients

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Abstract
Isotope renography was carried out in 64 kidney transplant patients attending a follow-up clinic. Graft survival in these patients ranged from 2 mo.-10 yr. Forty-one patients had normal renograms and 98% of these had satisfactory function (creatinine clearance greater than 50 ml/min). Eighteen patients showed a major renogram abnormality and 50% of these had impaired function. Five of these 18 have been explored and had graft complications (obstructive disease in 4, chronic pyelonephritis in 1). Exploration was not undertaken in the remaining 13 but 9 show evidence suggestive of graft pathology (proteinuria, impaired creatinine clearance, elevated urinary enzymes, calyceal distortion on IVP[i.v. pyelography]. A successful kidney transplant should result in a normal isotope renogram and a major abnormality of the renogram suggests the presence of a graft complication, even when the creatinine clearance is unimpaired. Renography was useful for identification of renal transplant patients who require further investigation or closer follow-up.