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November 12, 1973

Isotope Identification of Urinary Tract Abnormality In the Neonate

Author Affiliations

Downstate Medical Center Brooklyn, NY

JAMA. 1973;226(7):791. doi:10.1001/jama.1973.03230070051025

To the Editor.—  In QUESTIONS AND ANSWERS (225:319-320, 1973), the consultants differed on the need to perform an intravenous urogram (IVP) to detect genitourinary abnormalities in newborns having a single umbilical artery. For a variety of technical and physiological reasons, an IVP frequently fails to adequately show the neonate's urinary tract. Morbidity is encountered with reactions to contrast material and inadvertent overdosage has caused deaths in young infants.1As an alternative to IVP, a radioisotope study can be performed to screen those categories of neonates who have been shown to have a higher than expected incidence of genitourinary tract abnormalities. Several radioisotope techniques can be adapted to the infant.2,3 Isotope studies can provide reliable demonstration of renal blood flow, function, and size. In addition, vesicoureteral reflux can be detected with radionuclide cystography.4 The radiopharmaceutical agents employed appear to be innocuous, and the complications associated with IVP in