Is Comment Free? Ethical, editorial and political problems of
EDITORIAL COMMENT
Transcript of EDITORIAL COMMENT
1256 BACKGROUND SUBTRACTION AND RENAL FUNCTION ON RENOGRAPHY
14. Peters, C. A.. Gaertner, R. C. , Carr. M. C. and Mandell, J.: Fetal compensatory renal growth due to unilateral ureteral obstruc- tion. J. Urol., 150 597. 1993.
15. Bogaert. G. A., Mevorach, R. A. and Kogan. B. A.: Renal hemo- dynamic and functional effects of 10 days' partial urinary obstruction in the fetal lamb. J. Urol.. 152: 220, 1994.
16. Walker. R. D.: Editorial comment. J. Urol., part 2. 152: 602. 1994.
EDITORIAL COMMENT
These authors report a n important observation in analyzing differential renal function using mercaptoacetyltriglycine renogra- phy. Inconsistencies arise when assessing renal function in the right kidney, which is affected by overlapping hepatic activity. Their rec- ommendation for calculating differential renal function is to base it on a region of interest surrounding the whole kidney. For the pediatric urologist, nephrologist, pediatrician and so forth this con- cept is extremely important for 2 reasons: 1) in children the issue is more problematic due to smaller renal size and consequent inabil-
ity to separate adequately the kidney from adjacent extrarenal ac- tivity and 2 ) management decisions, such a s pyeloplasty. may be based on changes in differential renal function, particularly dow-n- ward changes. which may imply renal functional deterioration. Guidelines for pediatric nuclear imaging follow this recommendation as well. This important contribution helps explain the supranormal differential renal function measured by mercaptoacetyltriglycine and pentetic acid renography a t other centers tha t has previo"sly been rep0rted.I
M . nailid Gihhons Departriwnt of Pediatric linilogy Georgc~toii~ti Utiiiwrsity Mrtliccil ('prit<,r Wa.shington. I ) . C.
1 . Steckler, R. E., M c h r i e , G. A., Jaynathi. V. K., Gilday, D. L., Ash, J. M.. Churchill. B. N. and Khoury, A. E.: Contradictory supranormal differential renal function during nuclear reno- graphic investigation of hydroureteronephrosis. J. Urol.. par t 2, 152: 600, 1994.