title: [Prenatal diagnosis of hydronephrosis: utility of diuretic renography].
abstract: OBJECTIVE
  To investigate the value of diuretic renography in patients with prenatally diagnosed unilateral hydronephrosis.
  
  
  METHODS
  We reviewed 44 patients who underwent ultrasonography in the first week of life and 1 month after birth, and cystography and diuretic renography at 1 month to evaluate differential renal function and the diuretic washout pattern. Patients with vesicoureteral reflux were followed-up according to the protocol for this disorder. In the remaining patients, ultrasonography and/or diuretic renography was performed every 3-6 months.
  
  
  RESULTS
  In 4/44 patients vesicoureteral reflux was detected as cause a of hydronephrosis. In the remaining 40 patients, diuretic renography showed a washout pattern not suggestive of obstruction in 32 (only one patient needed surgery due to pyohydronephrosis). An indeterminate washout pattern was detected in one patient (who required surgery due to worsening of the washout pattern). A pattern suggestive of obstruction was detected in seven patients, four of whom required surgery (three due to a decrease in differential renal function and one due to worsening of the degree of pelvic dilatation).
  
  
  CONCLUSIONS
  Diuretic renography is highly useful in risk stratification and in the management of newborn infants with hydronephrosis since infants with washout patterns not suggestive of obstruction will rarely develop obstructive hydronephrosis and can initially be followed-up with ultrasonography alone. In indeterminate and obstructive patterns, however, close monitoring that includes diuretic renography is mandatory.
authors.affiliation: Servicio de Medicina Nuclear, Hospital Universitario de Getafe, Madrid, Spain. pilargarciaalonso@yahoo.es
authors.forename: M P
authors.initials: MP
authors.lastname: García Alonso
authors.forename: M
authors.initials: M
authors.lastname: Mitjavila Casanovas
authors.forename: F J
authors.initials: FJ
authors.lastname: Penín González
authors.forename: M A
authors.initials: MA
authors.lastname: Balsa Bretón
authors.forename: C
authors.initials: C
authors.lastname: Pey Illera
mesh_terms: D004232:Diuretics; D005260:Female; D006801:Humans; D006869:Hydronephrosis / Q000000981:diagnostic imaging*; D007223:Infant; D008297:Male; D011866:Radioisotope Renography; D016216:Ultrasonography, Prenatal
chemical_list: D004232:Diuretics