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Kidney function tests in children.

Total renal function is best determined by urinalysis and serum creatinine determination. This may be supplemented, under controlled conditions, by fractional urinary phenosulfonphthalein clearance. The excretory urogram, while invaluable as a diagnostic test, lacks quantitative value as a function test. Until recently, individual renal function determinations depended upon the difficult and tedious cystoscopy and bilateral ureteral catheterization and skilled laboratory techniques. Frequently the necessity of anesthesia artificially depressed kidney function. Since 1956, the radioisotope kidney function test has offered an external, innocuous means of assessing individual renal blood flow, function and drainage plus evaluation of vesico-ureteral reflux. The method has distinct advantages for evaluation of pediatric urological problems.

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[Kidney function tests].

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Glomerular Filtration Rate↗

[Validity of diagnostic methods for kidney function tests in the cat].

The diagnosis of kidney disease is difficult in the stage of compensation and impossible based solely on the routinely performed laboratory tests on blood and urine. For this reason, more sensitive methods are required. In the present study, three special techniques are compared with regard to their validity in the early diagnosis of kidney disease in the cat: 1. the molecular-weight related separation of urine proteins with the sodium-dodecyl-sulfate-polyacrylamide-gradient gel electrophoresis (SDS-page) in the PhastSystem, 2. measurement of the glomerular filtration rate (GFR) with the renalyzer PRX90 using an iodine containing contrast medium and 3. kidney scintigraphy. The results of this comparison demonstrate that these procedures are important adjuncts to common laboratory investigations in the testing of renal function. The SDS-page allows an early qualitative assessment on alterations of specific functional compartments of the kidney. However, it is not possible with this method alone to evaluate the degree of renal disturbance and it does not give information concerning the severity of renal functional impairment. Measurement of the GFR is also a valuable procedure which gives a quantitative result on the global renal function within a few hours. It is of special importance when subclinically disturbed kidney function is present. In the cat however it is until now not possible to give a correct prognosis in high grade nephropathies. Only scintigraphy allows unilateral assessment of renal function, which is most important in cats with morphologically altered kidneys, such as kidney cysts, hydronephrosis or tumours.

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