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To the Editor:—
Dr. Winter's comments are technical quibbling. The real point to be made is that the majority of people in the field have been referring to the total height of point "a" of the renogram as the "vascular spike." Dr. Winter now knows that at point "a" only 16% to 28% of the radioactivity is due to "vascular capacity." The misnomer "vascular spike" leads to attempts to interpret impaired renal blood flow from the first 1 to 2 minutes of the renogram curve. As Dr. Winter states, it is only during the first 17 seconds that a significant portion of the curve relates to radioactivity in the blood flowing into the kidney. In 50 patients studied with 1-131 albumin and 1-131 o-iodohippurate at 5-second time constant at a recording paper speed of 30 cm. per minute, we could not differentiate unilateral vascular abnormality in this 20-second segment. The
Wax SH, McDonald DF. Analysis of Sodium o-Iodohippurate Renogram-Reply. JAMA. 1962;180(10):901. doi:10.1001/jama.1962.03050230103025
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