Demonstration of Adaptive Functional Differences Seen in Kidneys Accompanying a Nonfunctioning/Hypofunctioning Partner, using Camera Based Tc 99m MAG3 Clearance Measurement Technique

OBJECTIVE The aim of this study was to demonstrate the functional compensation that occurs in kidneys which accompany a partner with total or partial loss of renal functioning mass, using camera-based Tc 99m MAG3 clearance technique. MATERIAL AND METHODS Eighty five patients (43M, 42F, age: 44.8±12.6, range: 18-77 years) with normal serum creatinine levels and normal (<Grade 1) Tc 99m MAG3 renogram curves were enrolled for this retrospective study. Patients were grouped as having; group 1: solitary normal kidney (unilateral atrophied/agenetic) (n=23), group 2: normal kidney with contralateral hypoplasic/hypofunctioning kidney (split renal function<30%), (n=24), group 3: bilateral normal kidneys (n=38). The measured camera based Tc 99m MAG3 clearances of normal kidneys in each group were compared. RESULTS Total Tc 99m MAG3 clearances (mL/min/1.73m2) were significantly lower in group 1 and group 2 compared to group 3 (281.5±46, 260.5±61.7 and 316.1±84, respectively). Highest isolated Tc 99m MAG3 clearances among normal functioning kidneys were observed in group 1 (281.5±45.6) followed by group 2 (204.4±55) and group 3 (157.5±44). Moderate negative correlation was detected between the Tc99m MAG3 clearances of normal kidneys and contralateral renal function (r=-0.5, p<0.001). CONCLUSION Normal kidneys can compensate for the loss of contralateral kidney function via increasing their clearances, which seems to be dependent on the residual function of their partner. Camera based Tc 99m MAG3 clearance measurement is an objective method to demonstrate compensatory differences in renal function seen between kidneys with contralateral normofunctioning, hypofunctioning and nonfunctioning partner. CONFLICT OF INTEREST None declared.