Diuretic Renography Findings in Patients With Acute Kidney Injury: A Pilot Single-Center Study

Objective: Etiological differentiation in acute kidney injury (AKI) is crucial, as it directly influences treatment strategies. Although renal scintigraphy is not routinely used in the evaluation of AKI, it may provide additional information regarding renal function and urinary drainage in selected cases. This study aimed to evaluate the contribution of renal scintigraphy findings to the etiological differentiation of AKI.Methods: This retrospective study included 17 patients who underwent renal scintigraphy for the evaluation of acute kidney injury. Demographic characteristics and accompanying comorbidities were recorded. Functional parameters assessed on renal scintigraphy included concentration function, excretory pattern, activity stasis, and diuretic response for both kidneys. The course of renal function was analyzed using follow-up serum creatinine levels and estimated glomerular filtration rate (eGFR) values.Results: The mean age of the patients was 59.0 ± 18.7 years, and 14 (82.4%) were male. Ten patients (58.8%) were classified as having prerenal AKI and seven (41.2%) as having postrenal AKI. No cases of intrinsic renal AKI were identified. Follow-up creatinine data were available for 16 patients; one patient in the prerenal group had missing follow-up data. Renal recovery was observed in 14/16 (87.5%) patients. The recovery rate was 100% in the prerenal group and 71.4% in the postrenal group (p = 0.175). No statistically significant differences in scintigraphic findings were detected between the groups; however, the small sample size limited statistical power. Delayed excretion in at least one kidney was detected in 80% of patients in the prerenal group and 100% of those in the postrenal group (p = 0.485).Conclusion: Diuretic renography may provide complementary functional information in selected cases of AKI, particularly for the assessment of urinary drainage and suspected obstruction. In this small pilot cohort, no statistically significant differences in scintigraphic findings were detected between prerenal and postrenal AKI; however, the limited sample size precludes definitive conclusions regarding etiological discrimination. Renography should be interpreted as an adjunct to clinical and anatomical imaging findings rather than as a standalone etiological test.