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Acute Parenchymal Dysfunction With Acute Anuria Induced by Retrograde Pyelography

Allen C. Alfrey, MD; Owen W. Rottschafer, MD; Martin P. Hutt, MD
Arch Intern Med. 1967;119(2):214-217. doi:10.1001/archinte.1967.00290200138016.
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ANURIA is a rare complication of retrograde pyelography. Early reports considered the mechanism "reflex."1 Bilateral ureteral obstruction has been demonstrated as the cause in a number of cases.2,3 This report describes a case in which bilateral ureteral obstruction was not present and suggests another pathogenesis for this complication: intrarenal obstructive nephropathy.

Report of Case  A 41-year-old man (No. 238301) was in good health until December 1964 when he noted the gradual onset of edema of the ankles, hands, and face. Urinalysis revealed 4+ protein and 3 to 5 red blood cells (RBC) per high power field and an occasional RBC cast. Urine protein excretion was 5 gm/24 hr and an intravenous pyelogram was normal. He was treated with prednisone, 60 mg daily, for at least six weeks without either clinical or laboratory improvement.On May 21, 1965, the patient was admitted to another hospital. Proteinuria and microscopic hematuria


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