Acute reactions to urographic contrast media

A prospective study of 3509 consecutive patients examined by excretion urography has been conducted to assess the incidence and significance of the untoward effects of urographic contrast media. Four compounds were used in doses containing 160 to 500 mg iodine/kg body weight. Toxic effects, arm pain, and allegic reactions were assessed separately, while the remainder were classified according to the influence of each reaction on the investigation and the need for treatment. From the results and a review of the literature we conclude that when there is a clear clinical indication for excretion urography a dose of contrast medium containing up to 600 mg iodine/kg body weight should be injected rapidly. Prophylactic antihistamine treatment and pretesting should be abandoned. Special care is needed for small infants and the lederly and for patients with renal or hepatic failure, myeloma, heart disease, or a history of previous major reaction. Full resuscitation facilities must always be available.