Radioisotope Renography

hgs. 144. 72s.) Lonidon: Baidiirc, 1Tindall & Cox, 1963. Dit. \xivlter speaks wvitlh authority onl thiis relatively new mietlhodi of inivestigationi, as he hlas t)een conicernled in its developmenlt from almost the be(ginning. lie gives a clear accounlt of the technique, dealinig xvith equipmenit, choice of radioactive test agent, anld interpretationi of renograms. He has included maniy examples of renograms, with clear explanlationis ol their interpretations. Hle compares the relative merits of renial function tests by an arl)itrary score based on "obtainability" of desired informiiatioin, degree of dilficulty of performanice of the test, risk involved, age of patienlt, etc. Tlhe choice of tests must always be related to the needs of the inldividualI patient and the facilities available, and such a comparisonl cailIlot be valid. It is liot necessary to make a case for radioactive renograms based on such a comparisoni, anid these tables ad(ld notlhing to the usefuliless of the book. Time radioactive renogram caii be easily and rapidly carried out with little discomfort to the patient. The amount of radiation to which the patient is exposed is extremely small, although nio amount is stated, and the tests can be repeated at short intervals to follow chailges in the patient's conldition. No side effects have been encountered in a large number of patienlts. Each kidney is tested separately. A specific pattern occurs in obstructive lesions, which reverts to normal after the relief of the obstruction. Unfortunately, this pattern is also founid in upper urinary tract stasis in its widest sense, such as polycystic disease or even in severe dehydration. In fact, the limitation of the method is that renograms are not pathogoniomic of disease states and must be interpreted in the light of informatioii collected in other ways, such as from intraveinous pyclograms. It appears to be a useful additional test iIl hypertenisive paticelts suspected of renal artery stemiosis, although it caminot replace arterography. One place where the method appears to be specially useful is in the diagnosis of ureteric reflux. M. G. MCG.