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Slot 6.1: Kidney. C = Renal corpuscle (only found in cortex). Medula. Medullary ray. Medullary ray. Medullary ray. Cortex. Slot 6.2: Diagram of nephron blood supply.

World Kidney Academy is a non-commercial organisations conceptualised and developed by professionals with proven credentials in education through distance ...

This article is published as part of a supplement sponsored by Kidney Disease: Improving Global Outcomes (KDIGO).

Slot 6.1: Kidney. C = Renal corpuscle (only found in cortex). Medula. Medullary ray. Medullary ray. Medullary ray. Cortex. Slot 6.2: Diagram of nephron blood supply. G = glomerulus. Vasa recta. V = vascular pole. Slot 6.3: Renal Corpuscle. C = Bowman’s capsule at urinary pole. Slideshow...

A determination of the glomerular filtration rate (GFR) with high accuracy is of great relevance especially in cases of insufficient kidney function.

Slot 6.5: Kidney a = vasa recta c = collecting duct d = distal tubules p = proximal tubules Arrows = Brush border Arrowheads = intercalated cells.

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Purpose Digital low-dosage, linear slot scanning radiography (Lodox®) is an imaging modality that can emit down to one-tenth the radiation of conventional X-ray systems. We prospectively evaluated Lodox® as a diagnostic imaging modality in patients with ureterolithiasis. Methods Conventional kidney–ureter–bladder (KUB) X-ray and Lodox® were performed in 41 patients presenting with acute flank pain due to unilateral ureteral stone confirmed by computed tomography. KUB X-ray and Lodox® images were then reviewed by four blinded readers (urology expert/resident, radiology expert/resident). Identification rates were compared using Pearson’s Chi square test. The impact of different parameters on stone identification by Lodox® was evaluated using logistic regression and generalized linear mixed models. Inter-reader agreement was tested using Cohen’s kappa coefficient. Results Median stone size was 5 mm (range 2–12), median stone density was 800 HU (range 200–1500). The identification rates of the urology expert were 68% for KUB X-ray and 90% for Lodox® (p = 0.014), and for all four readers 61% for KUB X-ray and 62% for Lodox® (p = 0.8). Radiation exposure for KUB X-ray and Lodox® was 0.45 mSv (SD ± 0.64) and 0.027 mSv (SD ± 0.038), respectively. Multivariable analyses showed an association between stone identification by Lodox® and stone size (p < 0.001), stone density (p = 0.005), lower body mass index (p = 0.005), and reader (p < 0.001). Conclusions The high identification rates and low radiation doses of Lodox® make it a promising imaging modality for the diagnosis of ureteral stones. Further validation in larger cohorts, including performance evaluation for renal stones, is warranted. Trial registration http://www.controlled-trails.com/ISRCTN12915426.

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Chronic Kidney Disease and Hypertension

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