Four cases of acute renal failure (A.R.F.) following high dose pyelography (H.D.I.V.P.) in diabetic patients with chronic renal failure are presented. Sodium methylglucamine ioxitalamate plus methylglucamine iotalamate were used together for H.D.I.V.P. All four cases developed oliguria for a brief period, but previous level of function returned within three weeks. From our observations and a review of the literature concerning the direct and indirect renal toxicity of the contrast dyes the different possibilities of the etiology of A.R.F. are cited. The association of red corpuscular damage, renal oedema, capsular hypertension, systemic hypotension and serum hypovolemia, all seem important factors in the development of A.R.F. in these patients with diffuse and severe vascular disease. In these cases the A.R.F. seems to be most often secondary to transitory renal ischemia. The evolution in these four patients, with oliguria of short duration and functional recuperation after the acute phase is consistent with this hypothesis. In two of the four cases other radiological examinations (pyelography and renal arteriography) were performed in the first few months after the acute phase without complications. In the second examinations, special care was taken to hydrate the patients well. Our conclusion is that H.D.I.V.P. is not contraindicated in patients with diabetic kidney disease, but they must be in a good state of hydration before the examination.
|Translated title of the contribution||Acute renal failure following high dose pyelography in patients|
|Number of pages||5|
|Journal||Union Medicale du Canada|
|State||Published - 1975|