Unilateral tubular obstruction: an unusual complication of urographic contrast media.

Arguiñarena, Francisco Javier Trueba; Alija, Juan José Fuertes; Homs, M. Pérez; Busto, E. Fernández del; Casado, Rosario Esteban

doi:10.2214/ajr.169.6.9393170

Cited by 3 publications

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“…Segmental, wedge-shaped nephrograms on delayed imaging studies have only rarely been reported. Anecdotal case reports were described by Ishikawa et al in 1985 [ 4 , 5 ], by Pazmino et al in 1983 [ 6 ], by Braedel et al in 1987 [ 23 ], and by Trueba-Arguinarena et al in 1997 [ 24 ].…”

Section: Discussionmentioning

confidence: 99%

Clinical Factors Associated with Dense and Wedge-Shaped Nephrograms Detected 24 h After Chemoembolization

Monsky

Pahwa

et al. 2009

Cardiovasc Intervent Radiol

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This investigation aimed to evaluate patient characteristics and procedural factors associated with abnormal nephrograms encountered on noncontrast computed axial tomography (CAT) obtained 24-h after transarterial chemoembolization (TACE) for primary and metastatic hepatic malignancies. Sixty hepatic chemoembolization procedures were performed in 29 patients who had a median age of 63 years (range 42-79). The male-tofemale ratio was 16:13. Noncontrast CAT scans were obtained approximately 24 h after TACE as part of our institutional protocol and were examined for persistent renal nephrograms. These findings were compared with clinical and procedural parameters to determine whether there was any association with these factors or with the occurrence of acute renal failure (ARF). Abnormally persistent CAT nephrograms were observed 24 h after 28 of 60 (46.7%) TACE procedures, of which 14 (23.3%) were persistent, bilaterally dense, global nephrograms, and 14 (23.3%) were small, wedge-shaped, and focal nephrograms. The change in serum creatinine from baseline to 24 h was significantly greater (p = 0.031) in the global nephrogram group. The presence of cirrhosis, Child-Pugh score, procedure time, baseline renal insufficiency, and lower periprocedural mean arterial blood pressure were also statistically significantly associated with the occurrence of bilateral globally dense nephrograms. The procedure time was statistically significantly associated with the occurrence of wedge-like focally persistent nephrograms. Global, persistently dense nephrograms and wedge-shaped focally persistent nephrograms are not infrequently observed after TACE. Persistent global nephrograms can be an important clinical indicator of ARF. The wedge nephrogram may represent focal renal ischemia.

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Section: Discussionmentioning

confidence: 99%

Clinical Factors Associated with Dense and Wedge-Shaped Nephrograms Detected 24 h After Chemoembolization

Monsky

Pahwa

et al. 2009

Cardiovasc Intervent Radiol

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“…Anecdotal case reports were described by Ishikawa et al [17] in 1985, by Pazimiño et al [18] in 1983, by Braedel et al [19] in 1987, and by Trueba-Arguinareña et al [20] in 1977. Yamazaki et al [21] reported focal residual contrast media in 16% (17/105) of patients by delayed CT at 24 h following abdominal angiography and found no association with CIN.…”

Section: Discussionmentioning

confidence: 99%

Persistent CT nephrograms following cardiac catheterisation and intervention: initial observations

Katzberg¹,

Monsky²,

Prionas³

et al. 2011

Insights Imaging

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ObjectivesTo describe persistent nephrographic patterns detected by unenhanced renal CT at 24 h after cardiac catheterisation and intervention.MethodsThis prospective study was Health Insurance Portability and Accountability Act-compliant and institutional review board approved. Twenty-nine patients (20 men, nine women; average age 63.27 and range 41–85 years) agreed to undergo unenhanced dual-energy computed tomography (CT) limited to their kidneys at 24 h after cardiac catheterisation. CT attenuation values (Hounsfield units) were made from the cortical and medullary regions and single kidney total parenchymal iodine values (milligrams) were measured. Spearman’s rank correlation coefficient and a two-sided Fisher’s exact test were used in the statistics.ResultsFocal nephrograms were observed in at least one kidney (range, one to five regions per kidney) in 10/29 (34%) of patients and bilateral global nephrograms in 13/29 (45%) of patients. Focal nephrograms correlated with cardiac catheterisation fluoroscopic time (r = 0.48; P = 0.0087). For global nephrograms, the total iodine content of right and left kidneys correlated with fluoroscopic time (r = 0.79 and 0.76; P < 0.0001, respectively) and the amount of contrast material (CM) used (r = 0.77 and r = 0.74; P < 0.0001, respectively).ConclusionPersistent focal and global nephrograms occur commonly as assessed by non-contrast CT at 24 h post cardiac catheterisation and our observations suggest they could be related to procedural factors.Electronic supplementary materialThe online version of this article (doi:10.1007/s13244-011-0131-2) contains supplementary material, which is available to authorized users.

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Scattered striated persistent nephrogram in sepsis

Sagiv¹,

Koslowsky²,

Korem³

et al. 2011

Nephrology Dialysis Transplantation

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Persistent nephrogram, the hallmark of radiocontrast-induced kidney failure, is usually homogenous throughout the kidney and is considered as a generalized shutoff of glomerular filtration, the consequence of altered glomerular hemodynamics, affecting most glomeruli. Herein, we report an incidental finding of scattered persistent nephrogram that was noted in a septic prediabetic hypertensive patient during computerized tomography-guided drainage of a liver abscess. The peculiar patchy striated distribution pattern suggests more centrally altered renal hemodynamics, with hypoperfusion at the level of interlobar and intralobular arteries. Altered renal microcirculation in this case is likely related to the combined effects of prediabetes, sepsis and contrast medium upon renal blood flow regulation, perhaps with consequent focal hypoxic tubular damage.

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Unilateral tubular obstruction: an unusual complication of urographic contrast media.

Cited by 3 publications

References 0 publications

Clinical Factors Associated with Dense and Wedge-Shaped Nephrograms Detected 24 h After Chemoembolization

Clinical Factors Associated with Dense and Wedge-Shaped Nephrograms Detected 24 h After Chemoembolization

Persistent CT nephrograms following cardiac catheterisation and intervention: initial observations

Scattered striated persistent nephrogram in sepsis

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