In three newborn infants who had received furosemide for a variety of indications, strongly increased echogenicity in the pyramids of the renal medulla was seen on ultrasonography. In one infant the changes were unilateral, the contralateral kidney being nonfunctional because of probable renal artery thrombosis. One infant died and medullary nephrocalcinosis was confirmed post mortem radiologically as well as by computed tomography and anatomic-histologic examination of the kidneys.

We investigated the value of real-time sonography for determination of pelvicaliceal dilatation 24-48 h after extracorporeal shock wave lithotripsy (ESWL) in 369 patients (419 treated kidneys). A varying degree of hydronephrosis was present in 121/419 (29%) kidneys. Fragmented stones post-ESWL were demonstrable in 346/419 kidneys (82%), but were missed by ultrasound in three kidneys (less than 1%). In four kidneys (1%), stone fragments which were shown to be present by ultrasound were not detectable on radiographs. In 25/419 kidneys (6%), evidence of renal trauma caused by ESWL was demonstrated by ultrasound. The most important incidental finding was a small renal cell carcinoma of the contralateral (untreated) kidney.

Forty-two patients presenting with chronic renal failure (serum creatinine 1.5--22.2 mg/dl) were examined with digital gray-scale ultrasound using high-frequency transducers. In 41 patients both kidneys were diffusely hyperechoic. Corticomedullary boundary could be defined in only a few patients. In one patient with focal glomerulopathy and mildly reduced renal function, the kidneys were ultrasonographically normal. The increased echogenicity of kidneys was not specific to any renal parenchymal diseases, and there was no definite correlation between the echogenicity of the kidneys, kidney size, and the degree of decrease of renal function.

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