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. 2015 Jul-Sep;31(3):245-8.
doi: 10.4103/0970-1591.156915.

F+0 diuretic protocol is superior to F-15 and F+20 for nuclear renogram in children

Ramesh Babu  1 , Dhandapani Venkatsubramaniam  1 , Easwaramoorthy Venkatachalapathy  2
Affiliations

F+0 diuretic protocol is superior to F-15 and F+20 for nuclear renogram in children

Ramesh Babu et al. Indian J Urol. 2015 Jul-Sep.

Abstract

Introduction: We compare the outcomes of three different diuretic protocols for renograms in children with hydronephrosis.

Materials and methods: Between August 2011 and July 2013, 148 diuretic renograms were performed to evaluate unilateral grade 3-4 hydronephrosis (reflux, posterior urethral valves, post-pyeloplasty status excluded). Patients were allotted into three groups based on the timing of diuretic administration: Diuretic given 15 min before (F-15), at the same time as (F + 0) and 20 min after (F + 20) radionuclide administration. Dynamic images and renogram curves were inspected to identify in each group (1) number of equivocal curves and (2) number of interrupted studies due to patient movement/discomfort/voiding. Statistical significance was determined by the Fisher exact test.

Results: There was no significant difference in age/sex distribution between groups F-15 (n = 35), F + 0 (n = 38) and F + 20 (n = 75). The number of equivocal curves was significantly less in F + 0 (2/38) and F-15 (3/35) compared with F + 20 (20/75). The number of interrupted studies was significantly less in F + 0 (2/38) compared with F-15 (9/35) and F + 20 (18/75).

Conclusion: The F + 0 and F-15 protocols are superior to the F + 20 protocol in reducing the number of equivocal curves, while the F + 0 protocol is superior to the other two in reducing interruptions due to patient movement or voiding. F + 0 is the diuretic protocol of choice for renogram in children.

Keywords: Diuretic protocol; hydronephrosis; nuclear renogram.

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Conflict of interest statement

Conflict of Interest: None declared.

Figures

Figure 1
Figure 1
The number of equivocal curves (represented in black) is significantly less in F + 0 (2/38) and F-15 (3/35) compared with F + 20 (20/75)
Figure 2
Figure 2
Two different protocols in the same patient with dotted lines representing normal drainage in the left kidney and solid line representing right kidney with hydronephrosis. The top image is a typical equivocal curve in the F + 20 study while the bottom image represents drainage in the F-15 study in the same patient
Figure 3
Figure 3
The number of interruptions (represented in black) was significantly less in F+0 (2/38) compared with F-15 (9/35) and F+20 (18/75)
Figure 4
Figure 4
Static image of nuclear renogram highlighting how patient movement could interrupt the study, as the region of interest moves out and the drainage curve gets distorted
See this image and copyright information in PMC

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