Evaluation of known or clinically suspected Acute or Chronic Pyelonephritis
Unspecified Kidney Infection
Evaluation of renal perfusion and function in the clinical setting of renal insufficiency or failure
Evaluation or renal or urinary tract abnormality due to recent trauma or surgery
Evaluation of reno-vascular hypertension in a patient with any of the following signs or symptoms:
failure to respond to at least 3 antihypertensive medications
accelerated or malignant hypertension
epigastric bruit
impaired renal function after treatment with an ACE inhibitor
progressive renal failure
recurrent pulmonary edema
sudden development of worsening of hypertension
unilateral small kidney discovered with any clinical study.
Evaluation of renal collecting system obstruction
Diagnosis of acute tubular necrosis
Diagnosis of renal transplant complications
Evaluation or renal or urinary tract abnormality due to recent trauma or surgery
Additional Indications for the Pediatric Population (under age 18):
Renal screening in a child with congenital heart disease
Dehydration
Failure to thrive
Septicemia of the newborn
Severe hemolytic anemia
Recurrent urinary tract infection
Vesicoureteral reflux
American College of Radiology. (2014). ACR Appropriateness Criteria® Retrieved from https://acsearch.acr.org/list.
Society of Nuclear Medicine Procedure Standards. http://www.snmmi.org/ClinicalPractice/content.aspx?ItemNumber=6414
