• Childhood Kidney Diseases
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• v.20 no.2
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• pp.88-91
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• 2016

Nephrogenic diabetes insipidus (NDI) can cause nonobstructive hydronephrosis. Congenital NDI (CNDI) is caused by a genetic mutation. This case report presents a 12-year-old girl who was incidentally diagnosed with nonobstructive hydronephrosis due to NDI caused by AQP2 gene mutation after being evaluated for microscopic hematuria found on routine health examination at school. The patient's medical and family history was unremarkable, and she complained of nocturia only at the time of the clinic visit. Bilateral hydronephrosis on abdominal ultrasonography prompted a water deprivation test, leading to diagnosis of NDI. Genetic study confirmed p.Asn (AAC)123Ser (AGC) in exon 2 of the AQP2 gene. Polyuria and hydronephrosis improved following arginine-vasopressin therapy. CNDI responsive to treatment should be considered as a possible cause of nonobstructive hydroureter.

• The Korean Journal of Nuclear Medicine
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• v.33 no.1
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• pp.57-64
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• 1999

Purpose: The purpose of this study was to evaluate the accuracy of Tc-99m DTPA diuretic renal scans in children with dilated upper urinary tract. Materials and Methods: We reviewed diuretic renal scans of 14 pediatric patients (age range: 3 days to 4 years) with unilateral hydronephrosis diagnosed by ultrasonography. Diuretic renal scan was done using Tc-99m DTPA and standardized protocol. In 3 neonates, diuretic renal scans were performed within 1 week and 3-7 months after birth. Results: Six patients required Pyeloplasty and eight were managed conservatively. All 6 patients requiring Pyeloplasty were diagnosed as having ureteropelvic junction obstruction in the diuretic renal scan. In these 6 patients, post-operative renal scans at 3-12 months after surgery were converted to nonobstructive pattern in 5 and a nonfunctioning pattern in 1. In 3 patients who underwent diuretic renal scan within 1 week after birth, nonobstructive patterns of initial scan were converted to obstructive patterns in the follow-up scan. However, all patients with nonobstructive diuretic renal scans performed after the neonatal period did well on serial ultrasonography and showed favorable clinical outcome without progression to obstruction. Conclusion: Tc-99m DTPA diuretic renal scan with standardized protocol is useful in assessing suspected ureteropelvic junction obstruction in children as an initial diagnostic or post-operative follow-up modality. Nonobstructive or indeterminate scan results in the neonatal period requires follow-up scan to monitor development of the obstructive pattern.

• Childhood Kidney Diseases
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• v.2 no.2
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• pp.178-182
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• 1998

Purpose : The conventional Whitaker test assesses the renal pelvic pressure response to a constant infusion rate of 10 mL/min in adult and 5 mL/min in children. We evaluated whether the infusion rate,5 mL/min is appropriate during Whitaker test in children. Materials and Methods : The study included 3 children with unilateral hydronephrosis, whose diuretic renography results were equivocal to define the presence of urinary obstruction. The kidneys were perfused at increasing flow rates from lmL/min. Results : There were intrapelvic pressure increases $26\;cmH_2O$ at 3 mL/min, $50\;cmH_2O$ at 2 mL/min and $80\;cmH_2O$ at 3 mL/min infusion rate, respectively. There was no need to increase the infusion rate over 4 mL/min to get a positive Whitaker test. Conclusion : Our experience with Whitaker test at variable low flow rates (1-5 mL/min) confirmed its usefulness in differentiating obstructive from nonobstructive uropathy. We recommend the increasing infusion rate from 1 mL/min during Whitaker test in children.