Shafi T, Chou S Y, Porush J G, Shapiro W B
Arch Intern Med. 1978 Aug;138(8):1218-21.
Acute renal failure (ARF) following infusion intravenous pyelography (IVP) has been reported in patients with chronic renal insufficiency, particularly diabetics. Renal function was evaluated before and after infusion IVP in 40 patients with chronic renal insufficiency. In 11 of 12 (92%) diabetics and 17 of 28 (61%) nondiabetics, a 25% or greater increase in serum creatinine values and/or decrease in creatinine clearance was noted after IVP despite adequate hydration in all patients. The maximum decrease in kidney function occurred within three days and usually returned to or near pre-IVP levels in seven to ten days. At least 70% of the patients had hypertension and/or evidence of vascular disease. The data suggest that preexisting vascular disease in the kidney, possibly associated with the known vasoconstricting effects of contrast media, may be an important factor in the ARF following infusion IVP.
静脉肾盂造影（IVP）后发生急性肾衰竭（ARF）的情况在慢性肾功能不全患者中已有报道，尤其是糖尿病患者。对40例慢性肾功能不全患者在静脉肾盂造影前后进行了肾功能评估。在12例糖尿病患者中的11例（92%）以及28例非糖尿病患者中的17例（61%），尽管所有患者均有充足的水化，但静脉肾盂造影后血清肌酐值仍升高25%或更多和/或肌酐清除率下降。肾功能的最大下降发生在三天内，通常在七至十天恢复到静脉肾盂造影前水平或接近该水平。至少70%的患者患有高血压和/或有血管疾病的证据。数据表明，肾脏中预先存在的血管疾病，可能与造影剂已知的血管收缩作用有关，可能是静脉肾盂造影后发生急性肾衰竭的一个重要因素。
