| ORIGINAL ARTICLE |
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| Year : 2022 | Volume
: 38
| Issue : 3 | Page : 216-219 |
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Comparison of two drainage parameters on diuretic renogram in predicting the fate of prenatally detected pelvi-ureteric junction-like obstruction
Gyanendra Ravindra Sharma, Anshu Gyanendra Sharma, Neha Gyanendra Sharma
Chitale Clinic Private Limited, Solapur, Maharashtra, India
Correspondence Address:
Gyanendra Ravindra Sharma
Chitale Clinic Private Limited, Solapur, Maharashtra
India
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/iju.iju_34_22
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Introduction: In infants with suspected pelviureteric junction (PUJ) like obstruction, we compared the drainage patterns suggested by t 1/2 and normalized residual activity (NORA) to determine which parameter can differentiate obstructive from nonobstructive dilatation and thus predict the need for surgery.
Materials and Methods: Infants presenting with prenatally detected PUJ-like obstruction from January 2014 to March 2020 were evaluated with ultrasonography. Diuretic renogram was performed using Tc99m ethylene dicysteine using the F0 protocol. Subjects with a differential renal function >40% were included in the study. The t ½ values were noted. NORA was calculated by dividing the tracer values at 60 min with the values at 2 min. The infants were followed using ultrasonography. Renogram was repeated if there was increase in hydronephrosis or after 6 months if hydronephrosis did not regress. The follow-up was continued till a decision for pyeloplasty was made or the hydronephrosis regressed. Pyeloplasty was advised if differential function dropped to below 40%.
Results: 34 patients met the inclusion criteria. NORA and t ½ had very poor concordance in defining the drainage pattern. t ½ values did not correlate with the need for surgery or conservative management (P ≥ 0.05). Good drainage pattern by NORA was associated with regression of hydronephrosis (P ≤ 0.001). NORA predicted obstruction more accurately.
Conclusion: NORA can define good drainage in a much larger subset of patients with PUJ-like obstruction who eventually do not need surgery. However, further multicenter studies are needed to confirm this.
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