Kidney X-ray with and without contrast

In diagnostics of urinary system diseases, X-ray examination of the organ plays a major role. Thanks to it, the location, configuration, structure, and pathological changes are determined. There are several methods of X-ray examination: without the use of a contrast agent (survey image) and with its use, allowing monitoring its movement inside the kidneys, ureter, and bladder.

Indications for the procedure

Cases that require renal x-rays include:

• lumbar pain, swelling;
• renal colic - possible signs of the presence of stones, tumors, cysts;
• deviation from the norm in the urine analysis of the following parameters: salts, leukocytes, specific gravity, erythrocytes;
• changes in biochemical blood analysis in the parameters of urea and creatinine;
• organ trauma;
• persistent urinary tract infections;
• detection of pathologies during ultrasound examination;
• suspicious smell of urine;
• monitoring the results of surgical intervention.

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Preparation

The quality of the photos largely depends on the correct preparation. In order not to have to go through this whole stage again, you should approach them responsibly.

Three days before the procedure, you must exclude gas-forming foods from your diet. What should you not eat before a kidney X-ray? There is no specific diet, but you must exclude beans, cabbage, milk, black bread, fruits, green onions, sorrel, and carbonated water from your menu.

The day before the X-ray, the last light meal should be no later than 18:00 ^. A cleansing enema is given in the morning.

To examine the bladder, you will need to fill it. 2 hours before the X-ray, start drinking liquid (plain water, non-carbonated mineral water, compote, sweet tea), you need to drink 1.5-2 liters in total.

If it is necessary to administer a radiographic contrast agent (iodine-containing drugs are used for this: urografin, omnipaque), an iodine tolerance test is performed.

Technique kidney X-rays

The stages of the X-ray depend on its type, which in turn is determined by the doctor's suspicions of a particular pathology. General X-ray is usually done in two positions. The patient takes off his clothes, exposing the kidney area, lies down horizontally, and a film in a cassette is placed under him. The other position is vertical, the image is taken standing.

With a contrast agent (excretory urography) - a more complex and lengthy procedure. The contrast agent is injected into a vein and excreted through the urinary system, coloring it. After 7 minutes, it enters the renal pelvis, at which time the first picture is taken. After a quarter of an hour, they are completely filled with the urethra (second picture), at 21 minutes - it penetrates the bladder (third picture).

This is what a standard procedure looks like, allowing you to track the dynamics of the entire urinary system from the kidneys to the bladder. If necessary, more images can be taken - up to 60 minutes after the contrast enters the body.

Suspicion of pathologies along the urethra is a reason to prescribe retrograde ureterography. To perform it, a "luminous" substance is introduced through a catheter inserted into the urinary tract.

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X-ray of the kidneys of a child

This examination is performed on a child if the ultrasound did not provide comprehensive information about the kidney disease. The dose of contrast agent is calculated based on body weight. Antihistamines may be prescribed to prevent allergies.

On the eve of the procedure (3 days before), children are given drugs that reduce gas formation, and are prohibited from drinking 7 hours before. The same requirements apply to food as for adults. On the day of the X-ray, parents should have a bottle of porridge or milk with them in case gases are detected, since when the stomach is full, they decrease.

During the actual imaging procedure, adults must ensure that the child remains motionless; for this purpose, they wear special lead aprons that protect them from X-ray radiation. Sometimes anesthesia is used because it is impossible to hold the child in a static position.

Contraindications to the procedure

Urography is contraindicated for use in the following cases:

• pregnancy;
• state of shock;
• renal failure;
• increased activity of thyroid hormones;
• iodine intolerance (contrast variant).

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Normal performance

Plain urography without contrast allows you to see:

• stones in the kidneys and urethra;
• displacement or prolapse of an organ;
• underdevelopment of the kidney, its doubling;
• abnormal anatomy of the bladder;
• Features of the urinary tract.

Excretory urography provides an assessment of the filling of organs with contrast, identifies areas of narrowing, and determines the filling of the bladder.

X-rays with contrast allow not only to detect the presence of stones, but also their size and location. Unfortunately, only calcium-containing compounds (phosphates and oxalates) can be seen on the image. Cystine and uric acid stones are detected by ultrasound, computed tomography and magnetic resonance imaging.

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Complications after the procedure

The consequences of the procedure may be related only to the body's reaction to the contrast agent, but usually the drug is administered slowly, doctors monitor the patient's reaction and are able to provide assistance in time. After the X-ray, there have been cases of dizziness, nausea, general weakness, and fever. Usually, such complications pass after a few hours. If this does not happen, you should consult a doctor.

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Care after the procedure

No special care is required after the procedure, but if the above-described reactions occur, you just need to lie down.

Reviews

There are no negative reviews about fluoroscopy of the urinary system, except for the preparatory period. It is not difficult to withstand restrictions in food, but the introduction of a large amount of liquid into the large intestine is a very unpleasant procedure. However, for the sake of truth, the success of treatment, people do not dwell on this.

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