Skip to main content
Log in

Imaging the kidneys and urinary tract in the neonate with acute renal failure

  • Practical Pediatric Nephrology
  • Published:
Pediatric Nephrology Aims and scope Submit manuscript

Abstract

Transitional nephrology seriously affects the manner in which radiological investigations and other forms of imaging are undertaken in the neonate. When this is complicated by acute renal failure then caution must be exerted in taking care of the neonate. The use of ultrasound and micturating cystourethrography are well described and form the baseline for all imaging of the renal tract. The physiological handling of TC99m DTPA and the contrasts used for IVU are described as well as the normal appearances of these techniques in the neonate. TC99m DMSA is also included, as are other modalities of imaging.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Spitzer A (1978) Renal physiology and functional development. In: Edelman CM (ed) Pediatric kidney disease. Little, Brown and Company, Boston, pp. 25–128

    Google Scholar 

  2. Tanner JM (1949) Fallacy of per weight and per surface area standards and their relation to spurious correlation. J Appl Physiol 2: 1–15

    Google Scholar 

  3. Coulthard MG, Hey EN (1984) Weight as the best standard for glomerular filtration in the newborn. Arch Dis Child 59: 373–375

    PubMed  Google Scholar 

  4. McCance RA, Widdowson EM (1952) The correct physiological basis on which to compare infant and adult renal function. Lancet II: 860–862

    Google Scholar 

  5. Friis-Hansen B (1961) Body water compartments in children: changes during growth and related changes in body composition. Pediatrics 28: 169–181

    PubMed  Google Scholar 

  6. Gruskin AM, Edelmann CM, Yuan S (1970) Maturational changes in renal blood flow in piglets. Pediatr Res 4: 7–13

    PubMed  Google Scholar 

  7. Olbing H, Blaufox MD, Aschinberg LC, Bernstein J, Spitzer A, Edelmann CM (1973) Postnatal changes in renal glomerular blood flow distribution in puppies. J Clin Invest 52: 2885–2895

    PubMed  Google Scholar 

  8. Rodriguez-Soriano J, Vallo A, Castillo G, Oliveros R (1981) Renal handling of water and sodium in infancy and childhood: a study using clearance methods during hypotonic saline diuresis. Kidney Int 20: 700–704

    PubMed  Google Scholar 

  9. Dillon MJ, Ryness JM (1975) Plasma renin activity and aldosterone concentration in children. Br Med J 4: 316–319

    PubMed  Google Scholar 

  10. Aperia A, Broberger O, Herin P, Zetterström R(1979) Sodium excretion in relation to sodium intake and aldosterone excretion in newborn pretern and full term infants. Acta Paediatr Scand 68: 813–817

    PubMed  Google Scholar 

  11. Al-Dahhan J, Haycock GB, Chantler C, Stimmler L (1983) Sodium homeostasis in term and preterm neonates. 1. Renal aspects. Arch Dis Child 58: 335–342

    PubMed  Google Scholar 

  12. Dean RFA, McCance RA (1949) The renal response of infants and adults to the administration of hypertonic solutions of sodium chloride and urea. J Physiol 109: 81–97

    PubMed  Google Scholar 

  13. Edelmann CM, Barnett HL, Troupkou V (1960) Renal concentrating mechanisms in newborn infants. Effect of dietary protein and water content, role of urea, and responsiveness to antidiuretic hormone. J Clin Invest 39: 1062–1069

    PubMed  Google Scholar 

  14. Britton KE, Brown NSG (1971) Clinical renography. Lloyd-Luke, London

    Google Scholar 

  15. Hilson AJW, Maisey MN, Brown CB, Ogg CS, Bewick MS (1978) Dynamic renal transplant imaging with Tc-99m DTPA (Sn) supplemented by a transplant perfusion index in the management of renal tranplants. J Nucl Med 19: 994–1000

    PubMed  Google Scholar 

  16. Chantler C, Garnett ES, Parsons V, Veall N (1969) Glomerular filtration rate measurement in man by the single injection method using51Cr-EDTA. Clin Sci 37: 169–180

    PubMed  Google Scholar 

  17. O'Connor JF, Neuhauser EBD (1963) Total body opacification on conventional and high dose intravenous uropgraphy in infancy. Am J Roentgenol 90: 63–69

    Google Scholar 

  18. Piepsz A, Denis R, Ham HR, Dobbeleir A, Schulman C, Erbsmann F (1978) A simple method for measuring separate glomerular filtration rate using a single injection of99mTc-DTPA and the scintillation camera. J Pediatr 93: 769–774

    PubMed  Google Scholar 

  19. Vivian G, Gordon I (1983) Comparison between individual kidney GFR estimation at 20 minutes with99mTc-DTPA and51Cr-EDTA GFR in children with a single kidney. Nucl Med Commun 4: 108–117

    Google Scholar 

  20. Diffey BL, Hall FM, Corfield JR (1976) The99mTc-DTPA dynamic renal scan with deconvolution analysis. J Nucl Med 17: 352–355

    PubMed  Google Scholar 

  21. Britton KE, Whitfield HN, Nimmon CC, Hendry WF, Wickham JEA (1979) Obstructive nephrophathy: successful evaluation with radionuclides. Lancet I: 905–907

    Google Scholar 

  22. Vivian GC, Barratt TM, Todd-Pokropek A, Gordon I (1984) Renal parenchymal determination and analysis during dynamic99m-DTPA scans in children. Nucl Med Commun 5: 35–40

    PubMed  Google Scholar 

  23. Levinsky NG, Levy M (1973) Clearance techniques.In: Orloff J, Berliner RW (eds) Handbook of physiology, vol 8: renal physiology. American Physiological Society, Washington, pp 103–118

    Google Scholar 

  24. Fetterman GF, Shuplock NA, Philipp FG, Gregg HS (1965). The growth and maturation of human glomeruli and proximal convolutions from term to adulthood. Studies by microdissection. Pediatrics 35: 601–699

    PubMed  Google Scholar 

  25. McCance RA, Naylor NJB, Widdowson EM(1954) The response ov infants to a large dose of water. Arch Dis Child 29: 104–109

    PubMed  Google Scholar 

  26. Suki W, Eknoyan G, Rector FC, Seldin DW (1966) Patterns of nephron perfusion in acute and chronic hydronephrosis. J Clin Invest 45: 122–131

    PubMed  Google Scholar 

  27. Barratt TM, Chantler C (1970) Obstructive uropathy in infants. Proc R Soc Med 63: 1248–1250

    PubMed  Google Scholar 

  28. Gosling JA, Dixon JS (1982) The structure of the normal and hydronephrotic upper urinary tract. In: O'Reilly PH, Gosling JA (eds) Idiopathic hydronephrosis. Springer, Berlin Heidelberg New York, pp 9–13

    Google Scholar 

  29. Gordon I (1985) Use of ultrasound and nuclear medicine techniques in paediatric urology. In: Whitaker RH, Woodard JR (eds) Paediatric urology. Butterworths, London, pp 34–42

    Google Scholar 

  30. Vivian G, Barratt TM, Todd-Pokropek A, Gordon I (1985) Physiological cariations of the normal transit time in children. Eur J Nucl Med 11: 179–181

    PubMed  Google Scholar 

  31. Piepsz A, Ham HR, Erbsmann F, Hall M, Diffey BL, Goggin M, Hall FM, Lumbroso J, di Paola R, Bazin JP, di Paola M, Fries D (1982) A co-operative study on the clinical value of dynamic renal scanning with deconvolutional analysis. Br J Radiol 55: 419–433

    PubMed  Google Scholar 

  32. O'Reilly PH, Testa HJ, Lawson RS, Farrar DJ, Edwards EC (1978) Diuresis renography in equivocal urinary tract obstruction. Br J Urol 50: 76–80

    PubMed  Google Scholar 

  33. Sulyok E, Varga F, Nemeth M, Tenyi I, Csaba IF,Ertl T, Györy E (1980) Furosemide-induced alterations in electrolyte status, the function of renin-angiotensin-aldosterone system, and the urinary excretion of prostaglandins in the newborn infant. Pediatr Res 14: 765–768

    PubMed  Google Scholar 

  34. Gruskin AB, Oetliker OH, Wolfish NM, Gootman NL, Bernstein J, Edelmann CM (1970) Effects of angiography on renal function in infants and piglets. J Pediatr 76: 41–53

    PubMed  Google Scholar 

  35. Grainger RG (1982) Intravascular contrast media, the past, the present and the future. Br J Radiol 55: 1–18

    PubMed  Google Scholar 

  36. Grainger RG (1986) The optimal concentration of contrast medium for aortography: a comparison of Hexabrix 320 and Hexabrix 250. Clin Radiol 37: 281–284

    PubMed  Google Scholar 

  37. Steiner RM, Grainger RG, Memon N, Weiss D, Kanofsky PB, Menduke H (1980) The effect of contrast media of low osmolality on the peripheral arterial blood flow in the dog. Clin Radiol 31: 621–627

    PubMed  Google Scholar 

  38. Cumberland DC (1981) Metrizamide in paediatric angiography. Ann Radiol 24: 99–104

    PubMed  Google Scholar 

  39. Dawson P, Howell M (1986) The non-ionic dimers: a new class of contrast agents. Br J Radiol 59: 987–991

    PubMed  Google Scholar 

  40. Gordon I (1986) Radiology and imaging of the urinary tract. In: Postlethwaite R (ed) Clinical paediatric nephrology. Wright, Bristol, pp 431–464

    Google Scholar 

  41. Hine AL, Lui E, Dawson P (1985) Contrast agent osmolality and plasma volume changes. Acta Radiol [Diag] (Stockh) 26: 753–756

    Google Scholar 

  42. Webster EW, Alpert NM, Brownall GL (1974) Radiation doses in pediatric nuclear medicine and diagnostic procedures. In: Jones AE, Wagner HN, Cooke RE (eds) Pediatric nuclear medicine. Saunders, Toronto, pp 47–52

    Google Scholar 

  43. Bingham JB, Maisey MN (1979) An evaluation of the use of99mTc-dimercaptosuccinic acid (DMSA) as a static renal imaging agent. Br J Radiol 51: 599–607

    Google Scholar 

  44. Goldraich NP, Alvarenga AR, Goldraich IH, Ramos OL, Sigulem D (1985) Renal accumulation of99mTc-DMSA in the artificially perfused isolated rat kidney. J Urol 76: 1282–1286

    Google Scholar 

  45. Goldraich NP, Goldraich IH (1982) Reflux nephropathy. Assessment using DMSA uptake. Int J Pediatr Nephrol 3: 120

    Google Scholar 

  46. van Luijk WHL, Ensing GJ, Meijer S, Donker AJM, Piers DA (1984) Is the relative99mTc-DMSA clearance a useful marker of proximal tubular dysfunction? Eur J Nucl Med 9: 439–442

    PubMed  Google Scholar 

  47. Siddiqui A (1985) Radiation doses for various radiotracers. In: Siddiqui A (ed) Nuclear imaging in pediatrics. Year Book Medical Publishers, Chicago, pp 3–17

    Google Scholar 

  48. Currarino G (1985) Normal findings and anatomical variants. In: Silverman FN (ed) Caffey's pediatric x-ray diagnosis, 7th edn. Year Book Medical Publishers, Chicago, pp 1610–1614

    Google Scholar 

  49. Rosenbaum DM, Korngold E, Teale RL (1964) Sonographic assessment of renal length in normal children. Am J Radiol 142: 467–469

    Google Scholar 

  50. Erwin BC, Caroll BA, Muller H (1985) A sonographic assessment of neonatal parameters. J Ultrasound Med 4: 217–220

    PubMed  Google Scholar 

  51. Blane CE, Bookstein FL, DiPietro MA, Kelsch RC (1985) Sonographic standards for normal infant kidney length. Am J Radiol 145: 1289–1291

    Google Scholar 

  52. Berdon WE (1985) Ultrasound in the neonate. In: Silverman FN (ed) Caffey's pediatric x-ray diagnosis, 7th edn. Year Book Medical Publishers,Chicago, pp 1890–1892

    Google Scholar 

  53. Atkinson GO, Kodroff MB, Gay BB, Ricketts RR (1985) Adrenal abscess in the neonate. Radiology 157: 221–224

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Gordon, I., Barratt, T.M. Imaging the kidneys and urinary tract in the neonate with acute renal failure. Pediatr Nephrol 1, 321–329 (1987). https://doi.org/10.1007/BF00849231

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF00849231

Key words

Navigation