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Current Role of Diuretic Renal Scintigraphy in Childhood

Publication at First Faculty of Medicine, Third Faculty of Medicine |
2010

Abstract

Nuclear medicine methods offer a possibility of renal evaluation of the genitourinary system in many nephrological abnormalities, including the follow-up to drug or surgical treatment, even in infants. Diuretic renal scintigraphy with intravenous application of the diuretic is a part of the investigative algorithms in many nephrological illnesses.

It is especially helpful in differentiating obstructions from hypotonia of the urinary tract. Obstructive hydronephrosis is usually diagnosed prenatally.

Pediatric nephrologists and urologists are faced with difficult tasks of not only correctly indicating the appropriate surgical procedure but also of determining the optimal timing of the intervention in terms of the pathological process, and the child's age and developmental stage. Especially during the first two years of life, it is crucial to follow closely the development of the pathological process to determine the appropriateness of a surgical intervention.

As yet, it remains unclear, however, which patients with obstructive uropathy will benefit from a surgery and under which conditions of the affected kidney should the procedure be performed. This paper provides a review of the current understanding and experience with this radionuclide method, which provides several parameters with the aim to assist the clinician in evaluating the pathological process of the kidney, especially in terms of the renal function.