Intravenous Pyelography in Unilateral Renal Disease

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Abstract
Comparison of intravenous pyelograms with glomerular filtration rate (GFR) was made in animals and man with severe unilateral pyelonephritis. The contralateral kidneys were free of advanced disease. Contrast visualization was obtained consistently bilaterally although GFR of diseased kidneys generally was below 10 ml per minute. Excretion of dye in radiopaque concentrations by these severely diseased kidneys presumably relates to the fact that they did not excrete an inordinately large percentage of filtered water. With a more marked reduction in total (ie, bilateral) nephron population, chronically diseased kidneys do excrete large fractions of filtered water, and in two dogs, contrast visualization could no longer be obtained after ureteral ligation of the contralateral organs. These studies underscore one of the pitfalls involved in employing pyelography as a quantitative test of renal function. They also permit deductions about causes of unilateral nonvisualization.

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