To Örebro University

Renography is a nuclear medicine examination that assesses the relative renal function of a patient’s kidney. The methodology includes intravenous administration of a radiopharmaceutical and dynamic image acquisition on a gamma camera. Some renographies can be supplemented with a diuretic, furosemide, to differentiate between obstruction and no obstruction. The overall aim was to improve the renography methodology to be both feasible and effective in clinical practice. Study I was a systematic review with the aim of identifying a preferred time point at which a diuretic should be administered in relation to radiopharmaceutical administration. The review revealed that several time points can be used, with no method being superior to the others. Study II was a retrospective study aimed at calculating a threshold to be used when deciding whether furosemide is required in a renography. A cut-off value of the remaining activity in the kidneys seven minutes into the examination was calculated, suitable to be used in clinical practice. Study III was a prospective study evaluating the renography acquisition time needed for physicians to conclude whether or not obstruction was present in kidneys and investigating whether a postvoid image would improve diagnostics. The results revealed the postvoid image to be valuable in some diuresis renographies. It was possible to shorten the acquisition time in renographies that did not involve a diuretic but generally not possible in diuresis renographies. Study IV used an inductive qualitative design involving interviews with adult diuresis renography patients. The study aimed at gaining an understanding of the examination process from a patient perspective. The results showed that patients experienced worries and inconveniences before, during and after the examination but still felt safe and well cared for by the working professionals.