Radiographic findings and hypotensive reactions in excretory urography

The radiographic findings and the hypotension patterns were reviewed in 19 patients having hypotensive reactions in routine excretory urography using ionic contrast medium. The lowest systolic blood pressure was above 80 mmHg in 10 patients while below 80 mmHg in remaining 9 patients. The urogram was unremarkable as long as the systolic blood pressure was preserved above 80 mmHg. In 2 patients, whose systolic blood pressure decreased quickly beyond 80 mmHg immediately after injection of contrast medium, the pyelogram was faint or non-visualized. On the other hand, in 4 patients, whose systolic blood pressure decreased beyond 80 mmHg in several minutes after injection of contrast medium and remained under 80 mmHg for more than 20 minutes, the nephrogram was dense and the pyelogram was faint or non-visualized. Although systolic blood pressure decreased beyond 80 mmHg, the urogram was unremarkable in 3 patients. This was due to the delayed hypotension or the short duration of hypotension.