Infusion intravenous pyelography and renal function. Effects in patients with chronic renal insufficiency

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Abstract
Acute renal failure (ARF) following infusion i.v. pyelography (IVP) was reported in patients with chronic renal insufficiency, particularly diabetics. Renal function was evaluated before and after infusion IVP in 40 patients with chronic renal insufficiency. In 11 of 12 (92%) diabetics and 17 of 28 (61%) nondiabetics, a 25% or greater increase in serum creatinine values and/or decrease in creatinine clearance was noted after IVP despite adequate hydration in all patients. The maximum decrease in kidney function occurred within 3 days and usually returned to or near pre-IVP levels in 7-10 days. At least 70% of the patients had hypertension and/or evidence of vascular disease. Preexisting vascular disease in the kidney, possibly associated with the known vasoconstricting effects of contrast media, may be an important factor in the ARF following infusion IVP.