Objective: The purposes of our study were to determine the effect of serial radioisotope renography on the diagnostic evaluation and therapeutic intervention of spinal cord injured patients and to determine the characteristics of renographic findings in spinal cord injured patients.

Method: Three hundred and two spinal cord injured patients were examined with radioisotope renography using Technetium-99m mercaptoacetyltriglycine. Forty-two of 302 patients were examined in serial studies. Intravenous pyelogram, urodynamic study, 24-hour creatinine clearance, and voiding cystourethrogram were also performed. Radioisotope renography was correlated with diagnostic procedures and therapeutic interventions. Therapeutic interventions included changes in medication and bladder management.

Results: The renal functions in the left kidney were better than the functions in the right kidney after spinal cord injury (p＜0.01). If neurogenic bladders were managed properly, renal functions improved after the shock stage of injury (p＜0.05). Patients with significant improvement in their renal function underwent changes in proper medication and methods of bladder management (p＜0.05). Renal function changes were correlated with the type of neurogenic bladder and maximal detrusor pressure (p＜0.05). No significant renal function changes were found between the groups according to the completeness of injury and gender.

Conclusion: Radioisotope renography is a good initial indicator to show problems that required management changes. Serial radioisotope renographic findings give valuable informations about the urinary tract in spinal cord injured patients.

Objective: The purposes of this study were to determine the renal function by radioisotope renography and to compare the findings of radioisotope renography in the spinal cord injured patients to the clinical presentations and findings of other conventional urologic examinations.

Method: Intravenous pyelogram(IVP), voiding cystourethrogram(VCUG) and urodynamic study were performed in twenty-five spinal cord injured patients along with serum BUN/Creatinine levels and 24 hour creatinine clearance tests. Technetium-99 m mercaptoacetyltriglycine was used for the radioisotope renography.

Results: One abnormal radioisotope renography finding was noted among 22 normal findings by IVP and VCUG studies, while no abnormal finding by IVP and VCUG studies was noted among the subjects with a normal radioisotope renography. Effective renal plasma flow(ERPF) was significantly lower in patients with lower creatinine clearance. ERPF, cortical retention and creatinine clearance values for hyperreflexic bladders were significantly different from areflexic bladders. ERPF was significantly higher in a clean intermittent catheterization group than in a percussion and Credé method group for the hyperreflexic bladders.

Conclusion: The study proves that the radioisotope renography is a sensitive and valuable study to evaluate the renal dysfunction in the spinal cord injured patients.