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Pyelorenal backflow in normal and ischemic rabbit kidneys

H S Thomsen, S Dorph, S Olsen

    Investigative Radiology
    |May 1, 1981
    PubMed
    Summary
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    Retrograde pyelography in rabbits shows pyelovenous and pyelosinous backflow commonly occurs at 70 mmHg. Intrarenal backflow, however, requires higher pressures and is more frequent during renal arterial clamping.

    Area of Science:

    • Urology
    • Nephrology
    • Radiology

    Background:

    • Retrograde pyelography is a common diagnostic procedure.
    • Understanding pyelorenal backflow is crucial for interpreting imaging findings and preventing complications.

    Purpose of the Study:

    • To investigate the incidence and pressure thresholds of pyelorenal backflow during retrograde pyelography in a rabbit model.
    • To assess the impact of renal arterial clamping on intrarenal backflow.

    Main Methods:

    • Retrograde pyelography was performed on 68 anesthetized rabbit kidneys.
    • Experiments included intact kidneys and those subjected to temporary renal arterial clamping.
    • Intrapelvic pressures were monitored, and contrast material distribution was analyzed, including histological examination.

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    Main Results:

    • Pyelosinous and pyelovenous backflow occurred frequently at an average intrapelvic pressure of 70 mmHg, even with arterial clamping.
    • Intrarenal backflow was rare in intact kidneys (1/35) but common during arterial clamping (8/9) at ~70 mmHg.
    • Subcapsular extravasation occurred at ~80 mmHg, and histological analysis revealed tears in the renal pelvis and parenchyma.

    Conclusions:

    • Pyelovenous and pyelosinous backflow are common during retrograde pyelography and occur at relatively low pressures.
    • Renal arterial clamping significantly increases the risk and lowers the pressure threshold for intrarenal backflow.
    • Histological findings confirm tears associated with different types of backflow, highlighting potential risks of overdistension.