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Abstract The aim of this study was to assess the efficacy of GFR measured using ROI from ultrasound technique in diuretic renography for evaluating postoperative outcomes in infants under one year old with congenital hydronephrosis. A retrospective analysis was conducted on thirty infants who underwent abdominal ultrasound and diuretic renography before and after surgery, obtaining preoperative and postoperative gGFRs and uGFRs (measured using ROI from ultrasound technique) determined using the Gates method and ultrasonic-assisted drawing ROI technique, respectively. A comparative study was performed on total GFR as well as individual kidney GFR before and after intervention. The preoperative and postoperative total and single uGFRs were significantly lower than gGFRs, while the postoperative total and single renal function, along with relative renal function in the hydronephrotic kidneys, were also significantly higher than the preoperative results (p