Intravenous Pyelogram Procedure
What is an intravenous pyelogram (IVP)?
Intravenous pyelography refers to a series of X-rays taken of the kidneys, their collecting or drainage system (the ureters), and the bladder. The ureters are the small tubelike structures that connect the kidneys to the bladder.
- An intravenous pyelogram (IVP) may be performed to detect a problem of the kidneys, ureters, and bladder. Most often, the IVP is done to locate a suspected obstruction to the flow of urine through the collecting system. The most common cause of blockage is a kidney stone. The IVP test also gives information about the functioning of the kidneys.
- In an IVP test, dye is injected via a catheter inserted in a person's vein, usually on the hand or the forearm. X-rays are then taken to follow the track of the dye through the system.
What are the risks of intravenous pyelogram?
The dyes (also called radio contrast media) are of 2 types: ionic and nonionic. Both types of dye contain iodine but differ in 2 key ways: the rate of adverse reactions and the cost.
Although the overall rate of adverse reactions is relatively low with both, there is a greater incidence of adverse reactions with the less expensive ionic dye than with the nonionic.
- Minor reactions, which are infrequent and do not last long, include flushing, nausea, vomiting, and itching.
- A small percentage of people experience a severe reaction to the dye, such as difficulty breathing, speaking, or swallowing; swelling of the lips and tongue; low blood pressure; or loss of consciousness. People who have had a severe reaction after receiving the dye once should not be exposed to it again.
- Pregnant women should not have an IVP because of the risk of radiation exposure to the unborn baby.
- People with known kidney disease or failure should not have an IVP because the dye can worsen kidney function.
- Elderly people and those with diabetes, high blood pressure, heart disease, or evidence of dehydration are at risk of developing kidney failure following administration of the dye.
- To avoid this complication, the kidney function should be tested with a blood test for creatinine, and the results should be known before the IVP is performed.
- Those with diabetes who are taking metformin (Glucophage) will have to discontinue this medication prior to and for 2 days after the IVP. They should inform their doctor of the test, and the doctor will coordinate their management during that time.
Medically Reviewed by a Doctor on 6/20/2016
Scott H Plantz, MD, FAAEM
Francisco Talavera, PharmD, PhD
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