Clinical Significance of Total and Separated Renal Clearance in Urological Practice Part 3 : Technique of the Split Renal Function Tests and its Application to the Diagnosis of Renal Hypertension

Abstract

Various methods were divised for the purpose of collec t i ng urine separatedly from each kidney. Successful collection was accomplished with use of special ureteral catheter. Clinical significance of the split renal function tests was discussed as to t h e diagnosis of renal hypertension. 1) Tests were performed in the morning under hydration with oral administration of water. Urine was collected from one kidney through an inserted ureteral catheter passed approximately 1 to 2 cm above the ureteropelvic junction and the other continuously through a vesical indwelling catheter. 2) Split function test was proved to be of significance in diagnosis of renovascular hypertension based on clinical and experimental studies. Separated CPAH, CSTS, Ccreat, concentration power, urine volume, electrolytes and creatinine in urine were helpful in its diagnosis. 3) The main arterial lesion showed decreased clearances of PAH, STS and creatinine, and increased creatinine in urine (Ucreat) and specific gravity of urine. Urinary sodium excretion (UNa) and urine volume were also decreased. The segmental arterial lesion showed redu c tion of urine volume, UNa and Ucreat on the affected side. No significant change was seen in PSP, clearances of PAH and STS. In the unilateral atrophic pyelonephritis clearances of PAH, STS and creat i n ine were decreased, and Ucreat and specific gravity of urine were also low. On the diseased side UNa was high, but reduction of the urine volume was not observed