Oliguria following Orabilix Administration

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Abstract
Cholecystography is usually regarded as a safe investigation, but recently renal complications have been described when Orabilix has been used as the contrast medium. Orabilix, 3(3-butyrylamino-2, 4, 6-tri iodophenyl)-2 ethyl sodium acrylate, is a brand of Buniodyl (Brit. Med. J., 1964) or Bunamiodyl. It is an iodine-containing oral cholecystographic agent, rapidly absorbed from the gut and excreted by the liver in much the same way as bilirubin and bromsulphthalein. Transient effects on bromsulphthalein excretion rates have been noted to occur and are probably due to temporary competitive interference. Maximum blood concentrations are found after one to three hours and because of butyrylation of the amine group 70 per cent is excreted by the kidneys. Bickham (1960) thought it to be safer than previously employed contrast media and he noted that side effects were uniformly lower than with other media. Several reports have appeared in the American literature linking the drug with renal toxicity (Rene and Mellinkoff, 1959; Gunn, 1961; Blythe and Woods, 1961; Gottlieb, Spiera and Gordis, 1962; Setter, Maher and Schreiner, 1963; and Wennberg, Okun, Hinman, Northcutt, Griep and Walker, 1963), but so far renal complications do not seem to have been experienced in this country, and it is for this reason that the present case is reported. The patient was a printers' reader, 23 years old, who had attended Guy's Hospital for many years because of tricuspid atresia, for which, in 1949, a left subclavian-pulmonary artery anastomosis had been performed.

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