The radionuclide assessment of pre-natally diagnosed hydronephrosis



Objective To determine if a pre-operative non-invasive radionuclide study can predict the results on surgery in infants with pre-natally diagnosed hydronephrosis.

Patients and methods Eight male infants with prenatally diagnosed hydronephrosis were treated by pyeloplasty within the first 4 months of life. All infants underwent a pre-operative diuresis renogram and a dimercapto-succinic acid (DMSA) scan, followed by a further renogram 6 months after surgery to assess renal function an drainage.

Results There was a significant difference between the resutls of the relative renal function estimates obtained by the pre-operative renogram and the pre-operative DMSA scan (P=0.001). In all patients the recovery in renal function following surgery was accurately predicted by the pre-operative DMSA scan.

Conclusion The results of this preliminary study suggest that a pre-operative DMSA scan could replace the use of invasive nephrostomy drainage to assess the potential for recovery in the poorly functioning neonatal kidney and give an indication of those kidneys most likely to benefit from recontructive surgery.