What is the significance of intravenous pyelography?

Kidney disease is one of the most common diseases in modern life. The importance of kidneys is indispensable to people because kidneys are organs that filter body fluids and other substances and can excrete useless substances from the body through urine. Kidney disease can affect this function and place a greater burden on the human body. Therefore, kidney disease is a disease symptom that people need to pay great attention to. Modern medicine recommends that people have regular physical examinations, including examinations of the kidneys. Intravenous pyelography is an advanced detection method. Let’s take a look at the significance of intravenous pyelography.

Intravenous pyelography (IVP) refers to a method of examining the entire urinary tract lesions by injecting contrast agent intravenously and excreting it into the urinary tract through the kidneys, so as to observe the renal parenchyma, renal pelvis, renal calyces, ureters and bladder. It is also called excretory urography. After the contrast agent is injected, it must first be filtered through the glomerulus and then concentrated and imaged through the renal tubules. Therefore, the filtration and concentration functions of the kidneys can be indirectly understood, and the morphology of the renal pelvis, renal calyx, ureter and bladder can be clearly displayed.

Preparation before the examination:

1. Perform an iodine allergy test and provide breath-holding training to the patient.

2. Avoid eating foods that are prone to producing gas or residue 2 to 3 days before the angiography, and avoid taking barium or iodine agents, as well as drugs containing calcium or heavy metals.

3. Take laxatives in the afternoon one day before the angiography. The elderly, those who are bedridden for a long time, and those who are habitually constipated can take laxatives every night 2 to 3 days in advance and do a cleansing enema 1 to 2 hours before the examination.

4. Do not eat or drink for 12 hours before the examination.

5. Take plain radiographs of the abdomen (kidneys and bladder) to determine whether conditions for contrast imaging are met.

6. Urinate before imaging to empty the bladder.

Clinical significance:

1. Used to examine organic lesions of the urinary tract, it can observe the location and cause of urinary tract obstruction; it can show contrast agent filling defects caused by urinary tract stones; it also has characteristic changes in the destruction of the renal pelvis and calyces caused by renal tuberculosis, chronic pyelonephritis (CPN), and renal pelvic tumors; in addition, it also has important diagnostic significance for renal parenchymal tumors, cystic kidney disease, solitary kidney, and renal ptosis. It is more suitable for patients who are not convenient to undergo cystoscopy.

2. Since hyperosmotic contrast agents are concentrated in the kidneys, they may damage renal function. Patients with renal insufficiency have unclear images due to reduced concentration capacity. If imaging is necessary, double or large doses of contrast agents can be used, but this is more likely to aggravate renal damage. Patients with renal insufficiency should be tested with caution. This examination is not recommended for patients with iodine allergy, severe cardiovascular disease, hyperthyroidism, etc.