Abstract
We reported the clinical course of a 21-day old female who presented postrenal acute renal failure from bilateral congenital hydronephrosis. She was detected as having bilateral hydronephrosis at about 23 weeks of gestation. She was delivered through cesarean section at 36 weeks due to the decrease of amniotic fluid volume. Through both antenatal and postnatal ultrasonography, renal pelvic dilatation was more prominent on the right side than on the left. Although we performed emergency placement of percutaneous nephrostomy first on the right kidney, electrolytes imbalance and elevation of SCr and BUN continued. We then placed the nephrostomy on the left kidney because the RI-renography done on 33th day revealed better differential renal function on the left, less dilated kidney. Renal function improved just after this procedure, and she went home 2 weeks after bilateral, simultaneous pyeloplasty. We discussed the importance of RI-renography to evaluate split renal function in small children with acute renal failure from bilateral hydronephrosis.
