title: ARF after retrograde pyelography: a case report and literature review.
abstract: Acute renal failure (ARF) occasionally occurs after intravenous injection of contrast medium, but complications are rare after retrograde pyelography. After reviewing the reports in the English-language literature, the authors found very few on those complications after retrograde pyelography. The authors present a patient who had ARF after the technique. The patient had a history of hypopharyngeal cancer with underlying serum creatinine level at the high end of the normal limits. Bilateral flank pain and decreased urine amount were noted soon after the procedure of retrograde pyelography. Subsequently, blood urea nitrogen and creatinine levels both elevated, and hemodialysis was needed. Several days later, diuretic phase took place. Thereafter, the symptoms subsided gradually. Pyelorenal extravasation of contrast medium was remarkable during the procedure. There was no evidence of hydronephrosis during the course of ARF. Early awareness and management may prevent the complications of ARF such as acute lung edema and hyperkalemia. Therefore, clinical physicians should be aware of the occurrence of ARF and its clinical presentation after performing retrograde pyelography.
authors.affiliation: Department of Internal Medicine, En Chu Kong Hospital, Taipei, Taiwan, China.
authors.forename: Yu Shin
authors.initials: YS
authors.lastname: Chiu
authors.forename: Hong Wei
authors.initials: HW
authors.lastname: Chiang
authors.forename: Chao Yuan
authors.initials: CY
authors.lastname: Huang
authors.forename: Tun Jun
authors.initials: TJ
authors.lastname: Tsai
mesh_terms: D058186:Acute Kidney Injury / Q000209:etiology*; D000368:Aged; D002295:Carcinoma, Transitional Cell / Q000000981:diagnostic imaging; D003131:Combined Modality Therapy; D004487:Edema / Q000209:etiology; D006801:Humans; D007012:Hypopharyngeal Neoplasms / Q000150:complications / Q000532:radiotherapy / Q000601:surgery; D007680:Kidney Neoplasms / Q000000981:diagnostic imaging; D008297:Male; D016609:Neoplasms, Second Primary / Q000000981:diagnostic imaging; D011183:Postoperative Complications / Q000209:etiology; D014517:Ureteral Obstruction / Q000209:etiology; D014567:Urography / Q000009:adverse effects* / Q000379:methods