urografin-76 and Kidney-Failure--Chronic

Radiographic contrast agents are associated with a number of adverse effects, including central nervous system effects and seizures. Almost all contrast agents are primarily filtered and excreted by the kidneys, and they accumulate in patients with end-stage renal disease. Brain retention of contrast associated with high doses is a rare event, having been reported only twice in the literature. We report a case of a 49-year-old male on chronic hemodialysis who developed brain retention of contrast resulting in seizures and encephalopathy after receiving large doses of meglumine/sodium diatrizoate during coronary angiography. He was treated successfully with hemodialysis and suffered no permanent neurologic sequelae. Patients with end-stage renal disease may be at increased risk of adverse effects from contrast when administered in high doses.

Topics: Brain Diseases; Contrast Media; Coronary Angiography; Diatrizoate; Diatrizoate Meglumine; Drug Combinations; Follow-Up Studies; Humans; Kidney Failure, Chronic; Male; Middle Aged; Renal Dialysis; Seizures; Tomography, X-Ray Computed

The authors compare the incidence of the changes established by X-ray, radioisotope-nephrographic and ultrasound studies on 115 patients with chronic pyelonephritis. Most frequent and most characteristic are the changes with venous urography. Though not specific, the changes in the isotope-nephrogram and ultrasound contribute to the establishment of functional and structural disturbances in chronic pyelonephritis. They have no contraindications for application, hence they are of high value in the presence of chronic renal insufficiency, where venous urographic is not effective. The ultrasound study has indisputable advantages in establishing the X-ray negative calculi, renal cysts and a functioning kidney.

Topics: Adult; Aged; Chronic Disease; Contrast Media; Diatrizoate; Diatrizoate Meglumine; Drug Combinations; Female; Humans; Iodohippuric Acid; Kidney; Kidney Failure, Chronic; Male; Middle Aged; Pyelonephritis; Radiography; Radionuclide Imaging; Ultrasonography