engleski

Diuretic Renal Scintigraphy In Infants With Antenatally Diagnosed Hydronephrosis

Objectives: Postnatal approach toward antenatally diagnosed hydronephrosis (ANH) remains controversial. Current algorithm of diagnostic procedures for postnatally confirmed ANH recommend VCUG as the first procedure. The aim of this study was to assess the place of diuretic renal scintigraphy in diagnostic procedures. Methods: The findings of diuretic renal scintigraphy (F+20) and VCUG were analysed in 37 infants with ANH confirmed postnatally by ultrasound. Eleven infants had bilateral and 26 unilateral hydronephrosis, which comprised 48 renal units (RU) for analysis. Results: In total, morphologically normal kidneys were found in 20 (41.7%) and normal diuretic response in 23 (47.9%) RU. In infants with bilateral hydronephrosis characteristic scintigraphic morphological changes were found in 6 out of 22 (27.3%) RU. The pathological diuretic response was found in 6 RU too (1 with obstruction, and 5 with intermediate response). In infants with unilateral hydronephrosis morphological changes were found in 22 of 26 (84.6%) RU. The pathologic diuretic response was registered in 19 of 26 (73.1%) RU (12 with obstruction, and 7 with intermediate response). Among all infants we found 5 with vesicoureteral reflux, in all cases unilateral. Three of them have morphological changes and one complete afunction. One had pathological (intermediate) diuretic response. Conclusion: Results of our study points that diuretic renal scintigraphy should be the first diagnostic procedure in postnatally confirmed ANH. It has no contraindications, it is easely perfomed, and the most important it has low radiation exposure. Unilateral hydronephrosis should be considered as more serious condition than bilateral hydronephrosis.

renal scintigraphy

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