Gassmann W, Haferlach T, Schmitz N, Kayser W, Löffler H
Schweiz Med Wochenschr. 1983 Feb 26;113(8):301-4.
Numerous reports refer to the development of acute renal failure following intravenous urography in patients with multiple myeloma, while other authors consider the risk to be acceptable if abdominal compression and dehydration are avoided and alkalization of urine is carried out. The outcome of 34 intravenous urographies with Conray 70, Conray FL, and Conray 36 has been evaluated in 26 patients with multiple myeloma. No case of acute renal failure was observed. Two patients experienced a mild increase (greater than 0.3 mg/dl) in serum creatinine levels. Mean value of serum creatinine was 1.28 mg/dl prior to and 1.18 mg/dl after urography. In three of four patients with preexisting azotemia serum creatinine levels fell after urography, while in the fourth a mild increase from 2.0 mg/dl to 2.5 mg/dl five days after the examination was observed. Data from the literature in addition to own data are presented. From all the data taken together we conclude that intravenous urography may carry a moderately increased risk of acute renal failure in patients with multiple myeloma. It may be performed if the indication is well established.
众多报告提及多发性骨髓瘤患者静脉肾盂造影后急性肾衰竭的发生情况，而其他作者认为，若避免腹部加压和脱水并进行尿液碱化，风险是可接受的。对26例多发性骨髓瘤患者进行了34次使用泛影葡胺70、泛影葡胺FL和泛影葡胺36的静脉肾盂造影，并对结果进行了评估。未观察到急性肾衰竭病例。2例患者血清肌酐水平轻度升高（超过0.3mg/dl）。静脉肾盂造影前血清肌酐平均值为1.28mg/dl，造影后为1.18mg/dl。4例原有氮质血症的患者中，3例静脉肾盂造影后血清肌酐水平下降，而第4例在检查后5天血清肌酐水平从2.0mg/dl轻度升至2.5mg/dl。除了自身数据外，还列出了文献数据。综合所有数据，我们得出结论，静脉肾盂造影可能会使多发性骨髓瘤患者急性肾衰竭的风险适度增加。如果适应证明确，可以进行该项检查。
