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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 an 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 as 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 at other centers that 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., Mchrie, 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.. part 2, 152: 600, 1994.

EDITORIAL COMMENT

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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.