Minimal set of investigations for UPJO or VUR

1. Urine dipstick

2. MSSU

3. Renal function assessment—serum creatinine estimation or more sophisticated techniques of renal function estimation (e.g., creatinine clearance)

4. USS—will demonstrate kidney size, thickness of the parenchyma, cortical echo-pattern, AP diameter of renal pelvis, calyceal ectasia, width of ureter, bladder wall thickness, and residual urine

5. MCUG—will confirm presence of VUR and allow grading. Also useful for evaluation of urethral valves

6. Static (DMSA) renal scintigraphy—ideal method for assessment of renal cortical morphology, infection changes, renal scars, and relative function estimation (avoid in the first 2 months of life)

7. Diuresis (MAG3) renography—to distinguish between obstructive and non-obstructive causes of hydronephrosis, and calculation of split renal function

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