AB1036 Features of kidney function and urodynamics at patients with chronic gout based on complex renal scintigraphy data
Authors: M. Gromova, O. Kislyak, V. Tsurko, A. Kashkadayeva, S. Averinova, S. Shiryaev
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> One of the frequent manifestations of gout is the gout nephropathy. For assessment of the urinary system functional reserves and the risk of renal failure routine analyses of urine in combination with a sonography are often not enough. Modern technology of the systemic examination of nephrourological status based on complex renal scintigraphy (SENS-CRS) was developed in the laboratory of radioisotope diagnosis in «N.N. Blokhin National Medical Research Centre» and realised as an automated workplace. SENS-CRS technology is designed for assessment of the urinary system functional reserves and the risk of renal failure at all macrostructural levels, and allows lowest radiation doses (0.6 mSv for one patient). <h3>Objectives</h3> To define features of kidney function and urodynamics at patients with chronic gout based on the complex renal scintigraphy (CRS) data. <h3>Methods</h3> 59 medical records of patients with gout (2007–2011) were analysed retrospectively. Most of the patients (95%) were men, average age was 54.4±9,5 years. Duration of the disease was 8<sup>4–11</sup> years. All patients had chronic gouty arthritis, 28% of patients had tophuses. The CRS tests was carried out on a two-detector gamma camera with simultaneous 2 projections recording. <sup>99m</sup>Tc-technephore was used, a Russian radiopharmaceutical (RP) from the group of bisphosphonates that has hemodynamics of a glomerulotropic product, concentrating mainly in the nephrons via filtration, with partial (10%–15%) involvement of secretion. Working protocol consisted of a base 21 min (1 min angiophase) study with administration of RP and a delayed 21 min study without administration of RP, but after taking 200–300 ml of water and/or an antispasmodic or diuretic drug to identify persistent urodynamic dysfunction. The interpretation of CRS data is based on a concentrational-hydrodynamic model of urinary excretion and SENS-CRS software. The Statistica 10.0 software was used too. <h3>Results</h3> According to CRS tests patients with gout had, on average, the level of blood cleansing from RP reduced slightly with a trend to a moderate level, and buffer retention of RP labelled blood in extrarenal structures increased. The signs of a relative hemostasis were found against the background of fast excretion accelerated by taking hypotensive drugs. Quantitative analysis of CRS data allows to estimate sustainability of relative urine delayes in the pyelocaliceal system (PCS): in 70% of patients residual urostasis in the renal parenchyma and groups of calyx remained relatively stable, and the urostasis signs in the renal pelvis were disappearing. This result means that there could be a latent increased residence time of substances such as uric acid as well as nephrotoxic drugs in the kidney parenchyma. This requires control of correct drugs dosage and when prescribing repeated therapy courses. <h3>Conclusions</h3> The SENS-CRS technology provides the quantitative assessment of kidney blood cleansing from RP and concentrational function of parenchyma as well as unique quantitative indicators of urodynamic delays in all parts of urinary tract. This kind of functional diagnostics allows to monitor parenchima and urinary tract condition promptly and with lowest radiation doses, apply therapeutic measures to prevent more severe kidney dysfunction and refer patients to a specialist consultation. <h3>Disclosure of Interest</h3> None declared