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Continuous infusion urography in unilateral hydronephrosis.

K G Naber, H Kuni, P O Madsen

The Journal of Urology

|September 1, 1975

Summary

Continuous infusion urography improves contrast medium concentration in hydronephrotic kidneys. This enhanced excretory urography technique aids diagnosis of unilateral obstruction, reducing risks associated with retrograde pyelography.

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Area of Science:

Radiology
Urology
Nephrology

Background:

Unilateral hydronephrosis presents diagnostic challenges for excretory urography.
Standard contrast medium administration is rapidly cleared by the contralateral kidney, limiting urine concentration in the obstructed kidney.
This necessitates alternative methods to enhance diagnostic accuracy in unilateral renal obstruction.

Purpose of the Study:

To evaluate continuous infusion urography for improved contrast medium urine concentration in unilateral hydronephrosis.
To assess the diagnostic efficacy and safety of this method compared to standard urography and retrograde pyelography.

Main Methods:

Theoretical computer modeling of contrast medium pharmacokinetics.
Animal experiments to validate the theoretical model.
Clinical application in 11 patients with unilateral hydronephrosis using prolonged infusion of large contrast medium doses (diatrizoate).

Main Results:

Continuous infusion urography significantly enhances urine concentration of contrast medium in the hydronephrotic kidney.
The method compensates for rapid excretion by the contralateral kidney, achieving diagnostic plasma levels.
Clinical use demonstrated improved diagnostic capabilities in unilateral obstruction cases.

Conclusions:

Continuous infusion urography is a valuable enhancement to excretory urography for diagnosing unilateral hydronephrosis.
This technique offers improved diagnostic potential and minimizes the need for invasive retrograde pyelography.
Further research can optimize contrast medium protocols for various renal function levels.

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