The intravenous urogram in acute renal failure

A patient with acute lymphoblastic leukemia, who developed acute renal failure, was imaged by computed tomography (CT). Persistent wedge-shaped areas of low attenuation in the kidneys were shown by sequential scans but no areas of infarction were found at autopsy. This case suggests that a wedge-shaped low-density lesion on CT may occur not only in infarcted areas, but also in areas where patchy vasoconstriction occurs.

Section: Discussionsupporting

confidence: 68%

Persistent Wedge-Shaped Low-Density Lesions on Computed Tomography of the Kidneys without Infarction

Sakemi

Kudo²,

Nagano³

et al. 1989

“…of obstruction [2,16]. The density/time pat tern of the nephrogram may point to particular causes of ARF [8].…”

Section: Discussionmentioning

confidence: 99%

Intravenous Urography in Experimental Acute Renal Failure

Sherwood¹,

Evans²

1978

Self Cite

We studied renal opacification during intravenous urography in 20 rats subjected to glycerol-induced acute renal failure, with and without prior saline loading. Animals drinking saline suffered less severe renal impairment (mean plasma creatinine 175 µmol/l) than those drinking tap water (mean 341 µmol/l). Nephrograms occurred during intravenous urography in 19 rats at all levels of renal impairment, but were only followed by pyelograms in 8 with mild plasma creatinine elevation (mean 84 µmol/l). The occurrence of a pyelogram was determined not by whether an animal was drinking saline or tap water, but only by the level of renal impairment. The presence of the nephrogram throughout the range of functional impairment in acute renal failure argues against glomerular filtration as the principal route by which contrast medium reaches the nephron to produce this clinically very useful sign.

“…Observations favouring this hypothesis were made by Bank et al [21] in mercury-poisoned rats, but there has been little support for this possibility by other experimental workers. Nevertheless, there is ample histological evidence of total disorganisation of proximal tubules as the predominant lesion in ischaemia [22], It is also interesting that in the human clinical syndrome of acute oliguric renal failure associated with tubular necrosis, an immediate dense, long-lasting nephrogram is seen re presenting large amounts of iodinated compounds in the renal parenchyma [23], These substances are normally filtered, and in the presence of anuria this phenomenon would be difficult to explain on the basis of alterations in ultra filtration dynamics alone.…”

Section: Discussionmentioning

confidence: 99%

Preservation of Normal Cortical Vasculature in Ischaemic Renal Failure in the Dog

Best¹,

Lavender²,

Russell³

et al. 1976

Self Cite

Ischaemic renal failure in the dog was studied by clamping one renal artery for 2 h in 18 animals. Total renal blood flow was measured for 3 h after this and only reduced by about 30%. Fine detail renal angiography showed a normal cortical perfusion pattern. Urine flow rates and creatinine clearances from these kidneys, however, were found to be grossly impaired over this period. Seven days later the angiogram of the oliguric kidney remained normal. Two-hour unilateral renal ischaemia in the dog leads to a form of acute renal failure with a striking disparity between glomerular perfusion and clearance, arguing against a primary circulatory defect.