Ja. Stock et al., CORRELATION OF RENAL BIOPSY AND RADIONUCLIDE RENAL SCAN DIFFERENTIAL FUNCTION IN PATIENTS WITH UNILATERAL URETEROPELVIC JUNCTION OBSTRUCTION, The Journal of urology, 154(2), 1995, pp. 716-718
To understand better the relationship among radionuclide renal scan di
fferential function, renal histology and the outcome of pyeloplasty we
performed ipsilateral renal biopsies in a series of patients undergoi
ng primary pyeloplasty. A total of 17 consecutive patients with unilat
eral ureteropelvic junction obstruction underwent renal biopsy at the
time of pyeloplasty. Biopsies were examined systematically after secti
ons were stained with hematoxylin and eosin, periodic acid, Schiff, Jo
nes modified silver or Masson trichrome stains, and they were reviewed
by 1 pathologist. Biopsy results were correlated with preoperative an
d postoperative radionuclide renal scan differential functions. Patien
t age ranged from 1 month to 7 years (mean 19.8 months). Renal biopsy
was abnormal in 6 kidneys, of which 5 had a preoperative differential
function of less than 33%. None of these kidneys had evidence of posto
perative improvement in renal function on followup scans despite a tec
hnically successful result. All remaining 11 kidneys had normal biopsi
es and a preoperative differential function of greater than 44%. We co
nclude from these data that patients with ureteropelvic junction obstr
uction with a differential function of less than 35% have a high proba
bility of significant histological changes on biopsy and a low probabi
lity of postoperative improvement in differential function.