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Effects in Patients With Chronic Renal Insufficiency

Tahir Shafi, MD; Shyan-Yih Chou, MD; Jerome G. Porush, MD; Warren B. Shapiro, MD

Arch Intern Med. 1978;138(8):1218-1221.

Abstract
Acute renal failure (ARF) following infusion intravenous pyelography (IVP) has been 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 three days and usually returned to or near pre-IVP levels in seven to ten days. At least 70% of the patients had hypertension and/or evidence of vascular disease. The data suggest that 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.

(Arch Intern Med 138:1218-1221, 1978).

Author Affiliations
From the Division of Nephrology, The Brookdale Hospital Medical Center, Brooklyn, NY.

Footnotes
Accepted for publication Oct 27, 1977.

Reprint requests to Division of Nephrology, The Brookdale Hospital Medical Center, Linden Blvd and Brookdale Plaza, Brooklyn, NY 11212 (Dr Porush).

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