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PubMed1990

Intravenous urography with iopamidol in children with reflux and obstructive nephropathy: effects on glomerular and tubular functions and the renin-angiotensin-aldosterone system.

Twenty-seven children [2 with chronic renal failure (CRF)] with reflux or obstructive nephropathy underwent intravenous urography with iopamidol 370, a nonionic contrast medium 1 (CM), osmolality 796 mosmol/kg, for renal growth evaluation. Mean iopamidol dosing was 1.69 ml/kg (range 1.22-2.42); the 2 children with CRF received 2 and 2.42 ml/kg respectively. One hour after infusion a significant decrease in haematocrit, haemoglobin, plasma sodium (Na+), chloride (Cl-), renin activity and aldosterone was observed, consistent with a possible plasma volume expansion due to the slightly hypertonic CM. At the same time there was a significant increase in fractional excretion of Na+, Cl- and potassium, probably due to the haemodynamic effects and tubular response to a substance acting as on osmotic diuretic. The -24 to +48 h monitoring of albuminuria, beta-2-microglobulin excretion, and in 4 children excretion of N-acetyl-beta-glucosaminidase and alanine-aminopeptidase did not show any relevant nephrotoxicity. No untoward effect of clinical relevance was observed.

Adolescent↗
PubMed1989

Urography versus DMSA scan in children with vesicoureteric reflux.

Following the diagnosis of primary vesicoureteric reflux, identified as part of the investigation of urinary tract infection, 299 refluxing kidneys in 202 children (aged 0-14 years) were prospectively evaluated using intravenous urography (IVU) and the DMSA renal scan at least 4 weeks after urine infection. There was 88% concordance between IVU and the DMSA scan, but in 12% there were discrepancies manifested in 37 kidneys from 31 children. Thirty-four kidneys were normal on IVU but showed scars of reflux nephropathy (RN) on the technetium 99m--dimercaptosuccinic acid (DMSA) renal scan; 4 of these (2 infants and 2 pre-school children) had severe generalized changes on scanning. Three kidneys were normal of DMSA scan and, although abnormal on initial IVU, were considered to be normal when this was repeated. During a follow-up period of 5 years an annual DMSA was undertaken in 194 patients and the renal scars remained unchanged in all except 1 child. The IVU was repeated 1-3 years after the initial study in 31 children in which the results of the first imaging did not agree. In 28 patients (34 kidneys) in which the initial IVU was normal but the DMSA abnormal, IVU evidence of scarring emerged in 30 of 34 kidneys, including the 4 patients with severe generalized damage on the DMSA. We conclude that abnormalities detected by the DMSA scan may precede the radiological findings, especially in young children. Even severe RN can be established in kidneys that appear normal on the IVU.

Adolescent↗
PubMed1979

Radiation gonad doses received by children in intravenous urography and micturition cysto-urethrography.

Measurements of gonad doses in intravenous urography (IVU) was performed on 47 children and in micturition cysto-urethrography (MCU) on 57 children. Ionization chamber dosimeters were placed rectally in girls and fixed on the scrotum in boys. Gonad dose ranged from 27 mrad to 201 mrad in girls and from 7 mrad to 112 mrad in boys during IVU; during MCU doses ranged from 53 mrad to 1900 mrad in girls and form 24 mrad to 309 mrad in boys. Risk of leukemia and genetic risk were calculated.

Adolescent↗
PubMed1981

Comparative evaluation of the diagnostic possibilities by urography, arteriography, scintigraphy and pharmacophlebography in traumatic lesions of kidney parenchyma in dogs.

Traumatic lesions of kidney parenchyma, not penetrating into the renal collective system, are the most frequent kidney traumas in man. The absence of typical clinical symptoms and the inability of comparing radiological investigations with the actual state are strongly limiting the diagnostic possibilities. The object of the present work has been to give a comparative evaluation of urography, arteriography, scintigraphy and pharmacophlebography in 22 dogs in which lesions of kidney parenchyma were performed operatively. From this work it follows that pharmacophlebography is of the greatest value because it detects traumatic lesions of the parenchyma in 80-100%. This method carries no risk even at an early period of kidney lesion, and does not lead to late changes in the parenchyma and kidney vessels.

Angiography↗
PubMed1978

Washout urography in the diagnosis of renal hypertension.

Washout urography was used as a screening test for 100 hypertensive patients. Eleven patients had renal hypertension. These were 4 cases of unilateral renal artery stenosis, 6 cases of unilateral pyelonephritis and one case of bilateral pyelonephritis with atherosclerosis of the right renal artery. The increase in size of the affected kidneys after Lasix injection was much restricted relatvie to the normal contralateral kidneys. The test proved valuable for screening cases of renovascular hypertension and unilateral pyelonephritis.

Adult↗
PubMed1986

Pre-prostatectomy intravenous urography--is it a must?

The value of intravenous urography (IVU) as a pre-operative necessity in patients with enlarged prostate is discussed. 150 IVUs were studied retrospectively, and on the basis of the findings it was concluded that it is still an important investigation in patients with "prostatism": 13.3% showed impaired renal function and back pressure changes, 21.3% showed coexistence of abnormalities and pathology of the urinary tract and 59.3% suggested enlarged prostate.

Aged↗
PubMed1986

Intravenous urography and voiding cystoureterography in northern Norway: a retrospective study.

Intravenous urography (IU) was performed in 489 patients aged 0-9 years during 1980-1983. A total of 35 (7.2%), 19 (13.1%) boys and 16 (4.7%) girls had pathological changes at IU. Of these, 11 boys and 5 girls had findings with therapeutic consequences. We have analysed the results of IU and voiding cystoureterography (VC) in 62 patients and show that a normal IU does not exclude vesicoureteral reflux into the renal pelvis. By performing only VC hydronephrosis, pyelonephritic scarring and anomalies may be missed.

Child↗
PubMed1987

Intravenous urography in children and youth.

This report derives from Tromsoe in northern Norway. In a retrospective study of the indications for intravenous urography (IU) and the findings at IU in 740 patients (451 girls and 289 boys) aged 0-19 years, we found that urinary tract infections accounted for 69.4% of the IU in females 30.1% of the IU in males, most often seen in the youngest patients. The pathological findings most frequently seen were anomalies (17 females and 10 males) and urinary tract obstruction (3 females and 15 males). The present study indicates the following: first, that the yield of IU in the primary investigation of children and youth suffering from enuresis and non-specific abdominal disturbancies is small; and second, that the use of IU in children and youth with urinary tract infection and haematuria should be questioned and reconsidered.

Adolescent↗
PubMed1989

Renal ultrasound and excretory urography in infants and young children with urinary tract infection.

The main purpose of the study was to see whether excretory urography (EU) can be safely replaced by ultrasound (US) in children with urinary tract infection (UTI) younger than 6 years. 101 hospitalised children were admitted to the prospective study. They were all diagnosed as having UTI and were treated accordingly. All children had voiding cystography (VCU), EU and US done. US and EU correlated well in 94% of the cases. In all 6 cases with discrepancy between EU and US, the VCU was abnormal. Our results confirm the data from other authors, that VCU and US should be sufficient as an initial work-up on children with UTI, while EU should be done only in the cases with abnormal findings on either one or both of the former investigations. However, it should be kept in mind that some cases of parenchymal involvement or mild subpelvic stenosis can be missed using this protocol. If EU is obtained only in the cases with abnormal US and/or VCU, only 55 children (54%) in our group would have had an EU done.

Child↗
PubMed1990

Ioversol for intravenous urography: a comparison study.

A new nonionic, low-osmolar iodinated contrast media, ioversol, was compared with another low-osmolar, nonionic contrast media, iohexol, in 80 patients undergoing intravenous urography. There were 40 patients in each contrast group. Patients were assessed for changes in vital signs, patient tolerance (heat and pain), and other adverse effects. Double-blind evaluation was also performed for comparison of the urogram image quality. There were no severe, life-threatening reactions for either contrast group. Ten patients (25%) receiving ioversol and seven (17.5%) receiving iohexol perceived body heat related to the injection of contrast material. Two patients (5%) in each group experienced mild nausea. Two patients (5%) of each group experienced noted unpleasant taste, and two patients (5%) of the iohexol group complained of headache. Vital signs remained stable without significant change in both groups, and image quality was considered equivalent. The results indicate that the two contrast agents are equivalent in image quality, safety, and incidence of adverse effects.

Adult↗
PubMed1990

Unequal doses of ioversol versus diatrizoate for urography.

A randomized, double-blind clinical trial was performed to compare a higher dose of conventional ionic contrast media (diatrizoate) with a lower dose of a new, nonionic contrast material (ioversol) for excretory urography (EU). One hundred twenty patients were randomized to receive either 100 ml of diatrizoate (Renografin-60) or 75 ml of ioversol (Optiray-320). Despite the lower iodine dose, the use of ioversol resulted in significantly better opacification of the calyces, renal pelves, and ureters. There was no significant difference in renal parenchymal opacification, opacification of the urinary bladder, or distention of the collecting system. We conclude that high-quality EU can be performed with a lower iodine dose using ioversol.

Adult↗
PubMed1982

Iopamidol in urography. A comparison between ionic and nonionic contrast media in patients with normal and impaired renal function.

The radiographic results obtained in urography with iopamidol, a new low osmolality contrast medium, given to 50 patients with normal renal function and 42 patients with impaired renal function, have been evaluated and compared with those obtained with ionic media of current use (meglumine sodium diatrizoate and sodium iothalamate). Based on this comparison, the authors believe there are no significant radiographic advantages to iopamidol.

Contrast Media↗
PubMed1986

Comparative effects of nonionic (iopamidol) and ionic (sodium and meglumine diatrizoate) contrast media for urography on urinary excretion of water and solutes.

Urinary water and solute excretion before and for 40 minutes after intravenous bolus injection of a nonionic (iopamidol) or an ionic medium (sodium meglumine diatrizoate) have been studied in subjects with normal renal function. Iopamidol produced less urinary losses of water, potassium, sodium, and chloride than did diatrizoate; uric acid excretion was also less enhanced. Surprisingly, both contrast agents produced a comparable increase in urinary pH and bicarbonate excretion. These data show that nonionic agents produce fewer changes in urinary excretion of water and solutes; the less enhanced excretion of uric acid after a nonionic medium may be an important reason to choose the latter agents for urography in patients at risk for urate neophropathy.

Bicarbonates↗
PubMed1989

Circumferential perirenal urinoma mimicking nephromegaly on urography.

Four cases of circumferential perirenal urinoma in patients with cancer are described. Intravenous urography showed evidence of apparent renal enlargement. In 1 case, opacification of extravasated urine was dense enough to be seen on the urogram, and the diagnosis was confirmed by computed tomography (CT). In the other cases, sonography followed by CT diagnosed urinoma, after tumor invasion had been suggested because of the pseudonephromegaly. Ureteral obstruction was demonstrated in all cases, due to retroperitoneal adenopathy in 1 case and to pelvic tumor in the other 3. Sonography or CT is required for the diagnosis of circumferential perirenal urinoma mimicking nephromegaly urographically.

Adult↗
PubMed1988

New and old contrast agents: pharmacology, tissue opacification, and excretory urography.

In equivalent doses for intravenous urograms conventional ionic contrast agents give iodine concentrations in the urine of approximately 30 mg iodine/ml, nonionic contrast media provide approximately 50 mg iodine/ml, and the ionic dimer Hexabrix approximately 70 mg iodine/mL. These new low osmolality, contrast media provide significantly higher urinary iodine concentrations than conventional ionic contrast media, provide better diagnostic quality excretory urograms, better patient tolerance, and fewer adverse side-effects and serious reactions. These new low osmolality, contrast media have significant advantages in intravenous urography in both safety and efficacy when compared to conventional higher osmolality contrast media.

Contrast Media↗
PubMed1983

Iohexol in urography.

Thirty patients injected intravenously with a nonionic contrast medium, iohexol, for urography were compared with 30 patients similarly injected with sodium iothalamate. Comparable radiographic results were obtained in these patients with normal renal function. Few minor responses were observed with the iohexol, suggesting that it may prove to be an attractive contrast medium for this purpose.

Clinical Trials as Topic↗
PubMed1985

Normal excretory urography in patients with primary kidney neoplasms.

The records of 65 consecutive patients discharged from the hospital with a diagnosis of primary parenchymal neoplasm of the kidney were reviewed. Four of the 65 patients had neoplasms which were not detected by excretory urography. The 4 undetected lesions included 3 renal cell carcinomas and 1 oncocytoma. All of these lesions projected from the anterior or posterior surface of the kidney, and all 4 were clearly demonstrated by computed tomography. Normal findings on an excretory urogram do not completely exclude a neoplasm of the kidney. When there is strong clinical suspicion of a renal neoplasm, computed tomography should be the initial examination or should be done even if the urogram has shown normal findings.

Adenoma↗