Renal Insufficiency after Oral Administration of a Double Dose of a Cholecystographic Medium

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

“…Thus, our patient with multiple myeloma is unique in developing acute renal failure after a single oral dose of 3 g of iopanoic acid, whereas, the 9 previously reported patients were given between 6 and 15 g of iopa noic acid. The patient reported here never recovered renal function in contrast to the other 9 reported patients [6][7][8][9][10]. The probable cause of acute renal failure induced by iodinated radio-contrast dyes is intraluminal obstruc tion of renal tubules by urinary proteins [4,5], In our patient, the excretion of large amounts of free light chains in the urine could have been the probable precipitating factor in the development of acute renal failure after an oral dose of iopanoic acid.…”

“…Earlier reports emphasized the role of intravenous pyelography in precipitating acute renal failure, but this incidence is probably low [1,2]. Acute renal failure after oral cholecystography with iopanoic acid (Telepaque) is rare and was reported to occur only after administration of a larger than usual dose [6][7][8][9][10]. Thus, our patient with multiple myeloma is unique in developing acute renal failure after a single oral dose of 3 g of iopanoic acid, whereas, the 9 previously reported patients were given between 6 and 15 g of iopa noic acid.…”

Renal response to environmental toxics

“…lodides: A number of cases of acute renal failure have been reported to occur following oral cholecystography (39,40) with the use of organic acids such as sodium buniodyl and iopancic acid (Telepaque). While the former has been withdrawn from the market and the toxicity from the latter is generally low, several factors seem to predispose to renal injury.…”

Etiology of Serious Reactions to Oral Cholecystography

“…Sodium tyropanoate (Bilopaque) was admin¬ istered to two groups : (a) 9 gm to five patients with Laennec's cirrhosis, two of whom were icteric ; (i>) 9 gm to four patients with no evidence of hepatic or renal disease. 4. Iopanoic acid (Telepaque) was administered to two groups : (a) 9 gm to seven patients with proved Laennec's cirrhosis, two of whom were icteric; (6) 9 gm to four patients with no evidence of hepatic or renal disease.…”

“…In the presence of marked hepatic derangement with or without jaundice, an increase in the dosage of cholecystographic media-even those as readily absorbed as bunamiodyl, sodium ipodate, and sodium tyropanoatewill not force visualization of the gallbladder or biliary tract. 4. In the presence of marked hepatic de¬ rangement the apaque media are shunted to the kidneys for elimination, the shunting re¬ sulting in high blood levels of these com¬ pounds.…”