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Paper Information

Journal:   IRANIAN JOURNAL OF KIDNEY DISEASES (IJKD)   DECEMBER 2009 , Volume 3 , Number SUPPLEMENT 1 (12TH INTERNATIONAL CONGRESS OF NEPHROLOGY, DIALYSIS, AND TRANSPLANTATION); Page(s) 18 To 19.
 
Paper: 

COMPARISON BETWEEN DIURETIC UROGRAPHY (IVP) AND DIURETIC ISOTOPE RENAL SCAN (DTPA) FOR DIAGNOSIS OF URETEROPELVIC JUNCTION OBSTRUCTION (UPJO) IN CHILDREN (POSTER PRESENTATIONS: P125)

 
 
Author(s):  ESMAEILI M., GHANE F., BANIHASHEM A.
 
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Abstract: 

Introduction. Ureteropelvic Junction obstruction (UPJO) is one of the most common causes of urinary tract obstruction in children. Several methods are used to diagnose upper urinary tract obstruction, including renal ultrasonography (US), intravenous pyelogram (IVP), diuretic renal scan, and antegrade or retrograde pyelography. Whereas nowadays it is suggested to use diuretic renal scan as the best method for diagnosis of UPJO, there is no comparative study between IVP and DTPA scan. The aim of the present study is to compare IVP mixed with furosemide and diuretic renal scan in diagnosis of UPJO.
Methods. This study is a cross-sectional investigation that was done on 40 children (28 boys and 12 girls) suspected to UPJO who had been presented with urinary tract infection (UTI), prenatal hydronephrosis, abdominal or flank pain, abdominal mass, and hematuria. Renal ultrasound was used as an initial screening tool for detection of urinary tract abnormality. Vesicoureteral reflux (VUR) was ruled out by voiding cystourethrography (VCUG). Serum creatinin, blood urea nitrogen, urinalysis, and urine culture was performed for all cases. IVP with furosemide and TC-99m diethylene triamine pentaacetic acid (DTPA) diuretic renal scan were performed as soon as possible.
Results. During a two-year period, 40 patients were diagnosed as UPJO.Mean age of the matients was 9.2 years (range, 40 days to 13 years). There was significant higher proportion of UPJO in the boys (70%) and in left side (65%). The sensitivity of renal scan in diagnosis of UPJO was 100% and sensitivity of IVP was 95%, respectively. Based on Mc-nemars test, there was a significant difference between the two procedures for diagnosis of UPJO (P < 0.001).
Conclusion. There was a significant difference between the two procedures (IVP and DTPA scan) for diagnosis of UPJO in kidneys with normal or near normal function; therefore, isotope DTPA-scan was the best method for diagnosis of UPJO. However, in many places such as small cities with fewer facilities, there is no advanced isotope imaging technology, use of IVP with diuretic maybe an acceptable procedure for diagnosis of UPJO.

 
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