Editorials: ACUTE RENAL FAILURE AFTER EXCRETORY UROGRAPHY IN MULTIPLE MYELOMA

Contrast Nephropathy

“…As awareness of the toxicity of contrast media has grown over the past few years, so have estimates of the frequency of complica tions. Several predisposing factors have been implicated; the most significant are preexisting renal insufficiency [8,18,20,22,[29][30][31][32][33] and diabetes mellitus [3,5,11,18,20,25,31,33]. Of the more than 250 published cases of con trast nephropathy, over 90% involved patients with renal insufficiency and over 50% involved patients with dia betes mellitus.…”

Nefropatia induzida pelos meios de contraste radiológico após cateterismo cardíaco diagnóstico e terapêutico

“…At first it was thought that this mechanism was responsible for the particularly high risk presented by these patients 32,33 . However, it is unlikely that this deposition will take place with the new contrast media and affect well-hydrated patients.…”

“…Multiple myeloma has been traditionally considered an independent risk factor for CMIARF 33 . A study review totaling 476 subjects with this condition failed to confirm that 67 .…”

Acute Renal Failure in Multiple Myeloma after the Ingestion of a Contrast Agent for Cholecystography

“…It is usually precipitated by hypercal cemia, infection associated with volume depletion or the administration of potentially nephrotoxic antibiotics. In a rare instance, intravascular injection of iodine-contain ing contrast dyes had led to acute renal failure [3][4][5]. We report here a patient with multiple myeloma who devel oped acute renal failure after a single oral dose of 3 g of iopanoic acid (Telepaque) as a contrast agent for chole cystography.…”

“…Progressive chronic renal failure in multiple myeloma patients is common and occurs at some time during this illness in about half of the patients [I, [3][4][5], In contrast, acute renal failure without preceding renal impairment is not common, occurring in only 8.7% of the patients re ported in a recent series [2]. Earlier reports emphasized the role of intravenous pyelography in precipitating acute renal failure, but this incidence is probably low [1,2].…”