Renal angiography

Renal angiography (administration of intravenous contrast dye to assess the vasculature of the kidney)... 

Bassilios N, Vantelon C, Cluzel P, Baumelou A, Deray G. Use of gadolinium-based contrast agent for renal angiography case report and review of the literature. Ren Fail 2001 23(6) 857-61. 

A 21-year-old man developed oliguria and uremia after 3 days of treatment with tranexamic acid 3 g/day for epistaxis. He did not recover. Renal angiography showed reduced cortical contrast enhancement, compatible with renal cortical necrosis. No other susceptibihty factors for renal cortical necrosis were present. 

Prostate sonogram Prostate-specific antigen PSA velocity Protein, urine Renal angiography Renal biopsy Renal scanning Renin assay plasma renal vein... 

In children with spontaneous hematuria, US can rule out urolithiasis or tumor. In renal failure, US can exclude renal vein or artery thrombosis (Laplante et al. 1993). Doppler US can confirm diagnosis and help follow-up of hemolytic-uremic syndrome (Patriquin et al. 1989). In children with palpable abdominal mass, US and plain film of the abdomen are usually sufficient to establish the diagnosis, which is then confirmed by enhanced CT or MRI. In patients with arterial hypertension, B-mode US can detect renal scar, hypoplasia, or nephropathy. Then, Doppler examination of renal vessels and parenchyma can orient diagnosis toward vascular cause. Renal angiography remains the reference examination (Garel et al. 1995). 

More specific laboratory tests are used to diagnose secondary hypertension. These include plasma norepinephrine and urinary metanephrine levels for pheochromocytoma, plasma and urinary aldosterone levels for primary aldosteronism, and plasma renin activity, captopril stimulation test, renal vein renins, and renal artery angiography for renovascular disease. 

The pharmacokinetics of X-ray contrast agents used in angiography and urography are practically identical. These are characterized by extracellular distribution followed by renal excretion by glomerular filtration. The terminal half-life is approx. 1.5 h. An overview of the existing data on pharmacokinetics of X-ray contrast media in humans has been given by Bourin et al. [5]. 

Other current applications of Ir-191m angiography include diagnosis of congenital circulatory defects (i.e., tetrology of Fallot) and vena caval obstruction. Potential applications that remain to be explored include measurement of ventricular volume, renal perfusion, cerebral blood flow, and evaluation of blood flow to tumors and organs by selective arterial infusion. 

If you would do an angioplasty or an operation, do classical renal arteriogram—not MRAor nuclear scan the only way to exclude renal artery stenosis as a cause of HTN is by selective transfemoral angiography to get details of main and branch renal arteries. 

Jakobsen JA, Berg KJ, Kjaersgaard R et al. Angiography with nonionic X-ray contrast media in severe chronic renal failure renal function and contrast retention. Nephron 1996 73 549-556. 

Eisenberg RL, Bank WO, Hedgock MW. Renal failure after major angiography can be avoided with hydration. AJR 1981 136 859-861. 

Diabetes is a major risk factor for deterioration in renal function after angiography (2,7,13). Other factors variably associated with increased rates of CIN include age over 75 years, anemia, female gender, periprocedural volume depletion, heart failure, cirrhosis, hypertension, proteinuria, concomitant use of nonsteroidal anti-inflammatory drugs, and intra-arteriai injection (2,4,5,7,10,13,14,19,43,44). In the setting of acute myocardial infarction or PCI, hypotension or use of an intra-aortic balloon pump has been associated with a higher rate of acute renal failure after exposure to a contrast medium (13,50). Finally, high doses of CM also increase the likelihood of renal dysfunction (51). 

Taylor AJ, Hotchkiss D, Morse RW, et al. PREPARED Preparation for Angiography in Renal Dysfunction a randomized trial of inpatient vs outpatient hydration protocols for cardiac catheterization in mild-to-moderate renal dysfunction. Chest 1998 I 14 1570-1574. 

Spargias K, Alexopoulos E, Kyrzopoulos S, et al. Ascorbic acid prevents contrast-mediated nephropathy in patients with renal dysfunction undergoing coronary angiography or intervention. Circulation 2004 I 10 2837-2842. 

X-rays, angiography and scans confirmed that Billie s problem was renal artery stenosis, a condition most commonly seen in females of20-50 years of age. Removal of the obstruction to renal blood flow is required to reduce BP permanently, but in the short term drug treatment will be needed to lower BP to an acceptable range. 

The use of gadolinium-DTPA as a suitable contrast agent in patients with renal insufficiency undergoing vascular intervention with standard X-ray screening has been reported (SEDA-22, 504). During angiography two... 

A 55-year-old woman with polycystic kidney disease and chronic renal impairment (serum creatinine concentration 181 pmol/l) received gadodiamide (Omniscan) for cerebral angiography there were no adverse effects and the serum creatinine was unchanged. (27)... 

---