We describe seven infants who developed renal calcification and bone demineralization following furosemide therapy with average daily doses of as little as 0.75 mg/kg per day. Renal calcifications were present in all seven cases and were more readily detected with ultrasonography than with plain films. Renal calculi were seen in four patients, sonographically demonstrated as echogenic foci in the dependent portion of the collecting system, usually accompanied by acoustic shadowing. One patient developed nephrocalcinosis, sonographically observed as echogenic medullary pyramids plus punctate, shadowing parenchymal calcifications. In two patients the location of the calcification could not be determined.

Six cases are presented in which the sonographic appearance of adrenal enlargement in the fetus or neonate mimics that of renal tissue. When normal renal tissue is not present, the adrenal preserves its characteristic echogenic medulla and anechoic cortex but enlarges, loses its characteristic "V" or "Y" shape, and appears more elliptical on ultrasound scans. The average length of the adrenal was 3.4 cm on the right and 2.9 cm on the left in these cases, with adrenal thickness increased to an average of 5 mm. Care must be taken not to mistake the enlarged adrenal for renal tissue. Conversely, an elongated adrenal gland without adjacent renal tissue does not necessarily imply renal agenesis, but may occur with renal ectopia.

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