title: F+0 diuretic protocol is superior to F-15 and F+20 for nuclear renogram in children.
abstract: BACKGROUND
  We compare the outcomes of three different diuretic protocols for renograms in children with hydronephrosis.
  
  
  METHODS
  Between August 2011 and July 2013, 148 diuretic renograms were performed to evaluate unilateral grade 3-4 hydronephrosis (reflux, posterior urethral valves, post-pyeloplasty status excluded). Patients were allotted into three groups based on the timing of diuretic administration: Diuretic given 15 min before (F-15), at the same time as (F + 0) and 20 min after (F + 20) radionuclide administration. Dynamic images and renogram curves were inspected to identify in each group (1) number of equivocal curves and (2) number of interrupted studies due to patient movement/discomfort/voiding. Statistical significance was determined by the Fisher exact test.
  
  
  RESULTS
  There was no significant difference in age/sex distribution between groups F-15 (n = 35), F + 0 (n = 38) and F + 20 (n = 75). The number of equivocal curves was significantly less in F + 0 (2/38) and F-15 (3/35) compared with F + 20 (20/75). The number of interrupted studies was significantly less in F + 0 (2/38) compared with F-15 (9/35) and F + 20 (18/75).
  
  
  CONCLUSIONS
  The F + 0 and F-15 protocols are superior to the F + 20 protocol in reducing the number of equivocal curves, while the F + 0 protocol is superior to the other two in reducing interruptions due to patient movement or voiding. F + 0 is the diuretic protocol of choice for renogram in children.
authors.affiliation: Department of Pediatric Urology, Sri Ramachandra Medical College, Porur, Chennai, Tamil Nadu, India.
authors.forename: Ramesh
authors.initials: R
authors.lastname: Babu
authors.affiliation: Department of Pediatric Urology, Sri Ramachandra Medical College, Porur, Chennai, Tamil Nadu, India.
authors.forename: Dhandapani
authors.initials: D
authors.lastname: Venkatsubramaniam
authors.affiliation: Department of Nuclear Medicine, Sri Ramachandra Medical College, Porur, Chennai, Tamil Nadu, India.
authors.forename: Easwaramoorthy
authors.initials: E
authors.lastname: Venkatachalapathy
keywords: Diuretic protocol; hydronephrosis; nuclear renogram