USE OF INTRARENAL NEEDLE MANOMETRY IN ACUTE RENAL DYSFUNCTION FOLLOWING RENAL-TRANSPLANTATION

Intrarenal manometry (IRM) using the Salaman fine-needle technique was routinely performed in 28 renal transplant patients in order to make the differential diagnosis of acute tubular necrosis, cyclosporin neph rotoxocity. and acute rejection. A total of 246 IRM determinations wit h simultaneous percutaneous renal biopsies were obtained in cases of a cute renal failure following a renal transplant. Normal IRM values wer e 21.4 +/- 1.3 mm Hg. After collecting the clinical data, cyclosporin levels, ultrasound information, response to therapy, and renal biopsy results, we retrospectively obtained 49 IRM measurements in acute reje ction, 9 in cyclosporin nephrotoxicity, and 26 in acute tubular necros is. The values in acute rejection (41.3 +/- 9.5 mm Hg) were significan tly different from the normally functioning kidneys, cyclosporin nephr otoxicity, or acute tubular necrosis. The values in cyclosporin nephro toxicity were slightly elevated when compared to the normal or acute t ubular necrosis determinations (p < 0.04) but were still significantly lower than the acute rejection. Our results suggest that IRM represen ts a useful technique in the approach to the acute renal dysfunction i n renal transplant recipients.