Acute renal failure in insulin-dependent diabetics: episodes secondary to intravenous pyelography

Diabetic patients with chronic renal failure are known to be at risk for exacerbation of renal failure if they undergo intravenous pyelography (IVP). The present report demonstrates that diabetic patients with normal serum creatinine levels can sustain irreversible renal failure following an IVP. The experiences with this case suggest that, if the creatinine clearance is decreased in an insulin-dependent patient irrespective of the serum creatinine value, one must be aware of the possible hazard of acute renal failure and irreversible renal damage following the IVP. This would appear to be especially true if the diabetic patient has proteinuria in combination with the decreased creatinine clearance.