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Renal cortical regions of interest were used prospectively to predict recoverability of renal function in 27 patients with unilateral or bilateral urinary tract obstruction. In these 27 patients 36 kidneys with short-term or long-term obstruction were studied. The 131iodine radiohippuran renogram curves were generated from areas of interest from the renal cortex and from the whole kidney. Curves generated during obstruction were evaluated qualitatively to determine if regional cortical renograms exhibited a more normal appearance than total kidney curves. After relief of obstruction renograms generated from the whole kidney were evaluated for evidence of renal functional recovery. Cortical curves obtained before relief obstruction were judged normal, with an abnormal whole kidney renogram in 20 of 36 kidneys. The whole kidney renogram improved after relief of obstruction in all 20 cases. Cortical curves for the remaining 16 kidneys before relief of obstruction had the same abnormal appearance as the whole kidney renogram. After relief of obstruction no evidence of kidney function improvement as measured by the renogram was evident in 14 kidneys. The over-all accuracy of this test of renal functional recoverability was 94 per cent. These data support the hypothesis that when cortical curves appear more normal than total kidney curves there is a strong likelihood of postoperative improvement in renal function when the obstruction is relieved. Abnormal cortical curves are associated with a poor prognosis for renal functional improvement.

Arteriovenous fistula of the kidney is a common complication of percutaneous needle biopsy with a reported incidence of as high as 15% in some series. Although a few cases eventually may develop hypertension, cardiomegaly, or congestive heart failure, most heal spontaneously within 1–18 months. Those which do not heal within this time are usually treated surgically and consequently there is little available information concerning the long-term conservative management of this problem. The subject of this report is a patient who has been followed medically for 10 years and who, despite the persistence of a large fistula, remains in good health.

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