Urography

Table 2. Properties of Ionic Monomeric Radiopaques for Angiography and Urography...

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]. 

For retrograde urography, many different water-soluble iodinated media can be used, provided they are diluted sufficiently. 

Delayed skin rashes have been noted in 5% of patients undergoing urography. AUergic-like skin reactions to intravascular contrast media can develop 24-96 hours after administration (204). 

The efficacy and safety of iodixanol has been documented in children. Iodixanol was well tolerated without any important adverse events in 25 children under 4-years-old undergoing excretory urography (254). 

The adverse effects of contrast agents during computed tomography (CT) are broadly similar to those during excretion urography, but the incidence of serious reactions and deaths may be higher, because reactions are harder to treat when the patient is in a scanner (SEDA-7, 451). Renal insufficiency can occur in patients with diabetes and pre-existing renal disease or as a result of multiple examinations. In Herpes simplex encephalitis. 

The use of intravenous urography has been in decline for some years with the advent of high-quality real-time ultrasonography (SEDA-20, 417). 

Retrograde urography is often followed by irritation and edema of the urethral and bladder mucosa. In animals this effect was maximal at 48 hours and persisted for at least 1 week. Factors that reduced the inflammatory response in the bladder were dilution of the medium and the use of smaller volumes instilled at lower pressure. In clinical use, diatrizoate has seemed to be less irritant than acetrizoate (305). 

Urinalysis after intravenous urography can give misleading results. Increased specific gravity, false positive tests for protein (with the sulfosalicylic acid and nitric acid ring methods, but not the bromophenyl dye test), and the presence of needle-like crystals have been reported. Pseudo-albuminuria can occur with a false-positive sulfosalicylic acid test (319). 

Stinchcombe SJ, Davies P. Acute toxic myopathy a delayed adverse effect of intravenous urography with iopamidol 370. Br J Radiol 1989 62(742) 949-50. 

Nunez ME, Sinues B. Cytogenic effects of diatrizoate and ioxaglate on patients undergoing excretory urography. Invest Radiol 1990 25(6) 692-7. 

Pfister RC, Hutter AM Jr. Cardiovascular radiology. Cardiac alterations during intravenous urography. Invest Radiol 1980 15(Suppl 6) S239 2. 

Reynolds NJ, Wallington TB, Burton JL. Hydralazine predisposes to acute cutaneous vasculitis following urography with iopamidol. Br J Dermatol 1993 129(l) 82-5. 

Jamet P, Lebas de Lacour JC, Christoforov B, Stern M. Acidose lactique mortelle apres urographie intraveineuse chez une diabetique recevant de la metformine. [Fatal case of metformin-induced lactic acidosis after urography in a diabetic patient.] Sem Hop 1980 56(9-10) 473. ... 

Lee S, Schoen I. Black-copper reduction reaction simulating alkaptonuria. Occurrence after intravenous urography. N Engl J Med 1966 275(5) 266-7. 

Katzberg RW. Urography Into the 21 century new contrast media, renal handling, imaging characteristics, and nephrotoxicity. Radiology 1997 204 297-312. 

Excretory urography does not reveal changes in the pyelocahceal system, except in cases with secondary infection or urothehal tumors. 

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