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Upper urinary tract dynamics was evaluated using diuresis renography during full and empty reservoir in 14 patients (11 men, 3 women, 13-70 years old) with intestinal urinary reservoir or intestinal bladder augumentation. Types of operation were Mainz pouch urinary diversion 5, Mainz neobladder to urethra 5, Kock pouch urinary diversion 2, and Mainz bladder augumentation 2. Diuresis renography was performed using 99mTc-DTPA and furosemide during full and empty reservoir, and several parameters (Tmax, T75, T50, GFR) in addition to the patterns of renogram were evaluated. In the normal control, none of the parameters of the diuresis renogram with full bladder differed from those with empty bladder. In 5 of 14 patients, abnormal waves on cystometry (CMG) were found, and in 4 of these 5 patients, the patterns of diuresis renogram of full reservoir were worse than those of empty reservoir. However, the patterns of diuresis renogram of full reservoir were not different from those of empty reservoir in 9 patients without abnormal waves on CMG. In conclusion, renal injury may easily occur in patients with intestinal reservoir and abnormal waves on CMG.

A 46-year-old housewife with regurgitation of mitral valve developed acute renal failure due to acute thrombosis of bilateral renal arteries after cardiac catheterization. A regional fibrinolytic therapy using transarterial infusion of tissue plasminogen activator (t-PA) was performed at 8 h after the onset, and was successful. She could be taken off hemodialysis 2 weeks after the fibrinolytic therapy, and could be successfully operated on with mitral valve replacement 7 months after that. Three years after mitral valve replacement, her serum creatinine was 148 mumol/l. This is the longest follow-up case after regional transarterial fibrinolysis of acute thrombosis of renal artery using t-PA, and this therapy is a safe and good one for acute thrombosis of renal artery.