ABSTRACTS PRESENTADOS AL 11th INTERNATIONAL SYMPOSIUM "RADIONUCLIDES IN NEPHRO-UROLOGY", REALIZADO EN MONTEREY, CALIFORNIA, 13-17 MAYO 2001.
23. DIURETIC RENOGRAPHY IN INFANTS WITH PRENATAL UNILATERAL HYDRONEPHROSIS-AN EXPLANATION FOR THE CONTROVERSY OF POOR DRAINAGE.
Isky
Gordon.
Great Ormond Street Hospital for Children. London WCI UK.
Aim:
To offer
an explanation of why impaired drainage on diuretic MAG-3 renograms
in infants with prenatal diagnosis of unilateral renal pelvic dilatation
(RPD) is not a sign of obstruction. The observation that impaired
drainage on diuretic renography postnatally does not always lead to
either loss of renal function nor an increase in dilatation over many
years has lead some to question whether impaired drainage is a sign
of obstruction in these asymptomatic infants. These infants are stable
both in terms of renal function and dilatation on follow up investigations
despite no surgical intervention.
Materials
& Methods. A theoretical model of the infant kidney is developed.
This is combined with an analysis of published works about the techniques
of undertaking and analyzing the diuretic renogram.
Results:
The results of theoretical model show prolonged drainage in numerous
different physiological situations found in early childhood, thus
offering an explanation why one may expect impaired drainage even
in the absence any obstruction.
The
table is a one year old. BSA of 0.5 M2
Conclusion: Understanding the phato-physiology of prenatally
diagnosed RPD will permit different interpretation of the diuretic
renogram and may affect treatment of these children.
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