Timely and reliable diagnosis is of great therapeutic value, since it directly affects the success of treatment. In the process of identifying kidney diseases, an effective diagnostic method is renal urology.
Urology of the kidneys
Urography is called an X-ray study, which allows to evaluate the functionality of the kidney structures and urinary system. The essence of the method is to introduce a contrast medium to the patient with a subsequent X-ray examination. Diagnosis can detect the presence of inflammatory foci, concrements or tumor formations. The procedure is prescribed to patients of any gender and age, since it is one of the safest studies.
Indications for prescribing
Urography shows how the patient's kidneys work, so it has a fairly wide range of appointments.
The study was performed to identify:
- Benign and malignant tumor lesions;
- Structural changes in renal tissues;
- Stones and small calculi in the kidneys;
- Abnormal structure of the urinary system and
- Probable consequences of kidney trauma;
- Nephrogenic hypertension, pyelonephritis, glomerulonephritis and hydronephrosis, tuberculosis, etc.;
- Causes of hematuria.
Urographic examination is prescribed for suspected genitourinary infections, with renal colic, as well as for obtaining a picture of the state of the kidney after an operative intervention. The method reliably determines the type and extent of the lesion, the stage of the pathological process, which allows the physician to select the most effective therapeutic tactics.
There are several types of urographic diagnostics:
- Infusion( intravenous using contrast medium);
Infusion( contrast) urography involves intravenous administration of a contrast agent with the help of a dropper. Usually, in such a study, contrast is slowly introduced during the procedure, and the pictures are taken at different stages of the diagnosis.
Overview urographic diagnosis is a standard radiographic study and is performed without the use of contrast. As a result of the research, a rather scanty picture of the disease is usually given, although the doctor, on the basis of the results of the survey urography, has the opportunity to detect large concretions and determine the general structure of the kidneys. Usually, such a procedure is always prescribed before contrast urography.
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This method is also called intravenous or contrast urography, as the procedure is performed using a radiopaque preparation. Usually Cardiotrast, Urografine, Visipac, Triambrast and others are used as a contrast. The method is based on the use of filtration renal function, excretion of recycled materials and release of metabolic substances.
The tubular-pelvis system is not visible in the survey urography, therefore, to determine its condition and functional capabilities, a contrast is introduced, on the choice of which the quality of the results depends. In order for the study to yield reliable and informative results, the contrast should not accumulate in the tissues, be metabolized and participate in real-exchange processes. In addition, the contrast drug should have minimal nephrotoxicity and maximum X-ray contrast.
On the video about excretory urography of the kidneys:
Absolute indications for intravenous urographic examination are:
- Urinary anomalies;
- Chronic inflammatory kidney lesions;
- Tumor processes in the kidney;
- Functional abdominal changes;
- Obstruction of the kidneys, etc.
Contrast urography is also often prescribed before the surgery.
Preparing for the
procedure Preparing for the review and excretory urography of the kidneys is somewhat different:
- The review study requires a preliminary GI cleansing. A few days before the study should be abandoned products that contribute to flatulence, such as bread, legumes, milk and potatoes. It is necessary to clean the intestinal structures with the help of sorbents( Polyphepan, activated carbon).On the eve of the review procedure and on the morning of the day it will have to be prepared by fasting, only unsweetened tea is allowed for breakfast. To avoid flatulence, it is not recommended to drink a lot of fluids.
- Preparing for intravenous urography of kidneys with contrast also requires cleaning the digestive tract so that renal imaging is maximally high. The patient must exclude the same products and follow the same rules as before the survey urography. Before the study, the patient is given a enema, then the patient must empty the bladder.
If the patient is nervous, then a sedative is recommended. If there is an allergy to any medications or chemicals, this should be notified in advance to the doctor. The patient is also required to sign a consent for the diagnosis.
How is the procedure
Urological examination of kidneys and adults and children carried out in an upright position, the X-rays are directed by a beam on the area of 3-4 vertebrae. During the exposure, the chest and genitals with limbs are closed with special protective equipment like an apron. After 5 minutes the patient can be free.
If we talk about how intravenous renal urography is done, then the procedure begins with the patient's placement on a special table, after which a contrast drug is slowly injected into the vein. In the process of introducing a contrast medium to children or adults, the patient may feel some discomfort like burning. X-ray contrast gradually penetrates into the ureters and kidney tissues. During excretory urography, several consecutive shots are taken at approximately 5-10 minute intervals.
During this time the patient is in a horizontal position, lying on the couch. Sometimes there is a need for delayed images, which are done several hours after the introduction of contrast. Usually the duration of intravenous urography is approximately half an hour-hour. After the procedure, the patient can go home and eat. Contrast introduction in infusion renal urography
Obstetric and excretory urography is not performed for all patients without exception, as the study has a number of contraindications:
- Severe form of hepatic or renal damage;
- Pregnancy, breast-feeding;
- Glomerulonephritis and other severe pathologies;
- Thyroid pathologies like thyrotoxicosis, etc.;
- Allergy to contrasting iodine preparations;
- Bleeding or tendency to bleed;
- Reduced blood flow;
- Kidney failure in acute or chronic form;
- Treatment of diabetes by Glucophage.
What harm does the
Urological diagnosis of the kidneys can be accompanied by adverse reactions of the body, which are usually manifested in the following:
- Burning sensation in the vein where the contrast was injected;
- Sensation of nausea;
- Hot flushes;
- Iron taste in the mouth.
But such reactions are considered normal and soon disappear on their own. In order for the contrast to get out of the body, it is recommended to use more liquid like fruit juices, green tea or milk. If there are no contraindications to conducting urographic diagnosis of the kidneys, then there are no side effects, and the possible harm is reduced only to short-term X-ray irradiation.
Urography in children is a safe procedure, it is conducted in them as well as in adults, only the dosage of contrast is determined with particular severity based on the weight of the child and the condition of his kidneys and liver. Since small children can not stay for a long time in a stationary state, they have radiopaque diagnostics with a shorter time interval. To rule out the likelihood of an allergic reaction, children are additionally given antihistamines.
When evaluating the results of urography, the doctor analyzes the location and shape of the kidneys, and also notes the speed of the extraction of the radiopaque substance. The parenchymal structures, the cup-and-pelvis system and its functionality are evaluated. There are obstacles to normal urine flow, insufficient filling of urine, etc.
Urea and kidney stones are detected in urography, but only later they become visualized to the final pictures, because at the beginning of the diagnosis the stones are darkened with contrast. If in the process of diagnosis there is no progress of contrast on the kidneys, it is possible that the kidney is absent, it is underdeveloped or blocked by a stone. Sometimes a similar pattern occurs with a severe degree of hydronephrosis.
Do not be afraid of urological research, either to children or adults, since revealing kidney pathology at an early stage maximizes the chances of a successful recovery.