Intravenous urography used in diagnosis of kidney diseases

Abstract

Intravenous urography is a test that uses X-rays and a special dye to help assess the kidneys, ureters, bladder and urethra. Intravenous urography (also known as intravenous pyelography) is an X-ray procedure which is used to assess problems in the kidneys, ureters, bladder and urethra. With intravenous urography a contrast dye is injected into a vein ('intravenous' injection). The dye travels in the bloodstream, concentrates in the kidneys, and is passed out into the ureters with urine made by the kidneys. The dye blocks X-rays so the structure of the kidneys, ureters and bladder shows up clearly as white on X-ray pictures. The X-ray pictures produced are called an intravenous urogram (IVU). Intravenous urography can help to assess a range of problems. For example: Kidney stones: A stone in a kidney or in the tube which goes from a kidney to the bladder (the ureter) will normally show up quite clearly. Urine infections: If you have infections of the bladder or kidney which is recurrent, an IVU may help to find if you have a blockage or other abnormality of the urinary tract. Blood in the urine: This can be due to various causes such as infection, inflammation and tumors of the kidney, an IVU may help to clarify the cause. Obstruction or damage to any part of the urinary tract can often be seen on an IVU. Contrast dye is then injected into a vein in your hand or arm. The dye then starts to filter through the kidneys into the tubes which go from each kidney to the bladder (the ureters). A series of X-ray pictures is then taken over your tummy (abdomen), usually every 5-10 minutes. You stay on the couch between each X-ray picture, but you may be asked to get up to empty your bladder before the final X-ray picture is taken. The procedure usually takes about 30-60 minutes. However, some pictures may be taken hours later in certain circumstances. You can eat normally straight afterwards. An allergic reaction to the dye occurs in a small number of cases. Symptoms may be mild - for example, an itchy skin rash and some mild swelling of the lips. More severe symptoms are rare - for example, breathing difficulties and collapse due to low blood pressure. It has to be stressed that severe reactions are rare, and the hospital department doing the procedure will have access to full resuscitation equipment, should it be needed. Intravenous urography is not done as often as it used to be. This is because of the development of other scanning techniques. Certain kidney problems are now more commonly assessed with techniques such as ultrasound scan, CT scan and MRI scan.