Nephrotomography
Norm of Nephrotomography
Normal kidney size, shape, and position.
Usage of Nephrotomography
Adrenal tumor, carcinoma of the kidney, nephrolithiasis, polycystic kidney disease (diagnostic when used in conjunction with ultrasound), and renal laceration.
Description of Nephrotomography
Radiographic examination of a single plane of renal tissue. It is a routine procedure performed during urography. Delineates renal borders and aids in distinguishing cystic from solid lesions. Precisely locating the kidneys, however, can be difficult. Nephrotomography may be performed with excretory urography (intravenous pyelography). The use of this test for detection of nephrolithiasis is decreasing as the newer technique of three-dimensional spiral computed tomography equals the accuracy of nephrotomography for this purpose.
Professional Considerations of Nephrotomography
Consent form IS required.
Risks
Radiation exposure, allergic reaction to contrast media (itching, hives, rash, tight feeling in the throat, shortness of breath, bronchospasm, anaphylaxis, death), contrast-induced renal failure.
Contraindications
Pregnancy; previous allergy to dye, iodine, or shellfish; pregnancy (because of radioactive iodine crossing the blood-placental barrier); renal insufficiency.
Preparation
- Have emergency equipment readily available.
- Residual barium from prior studies should be completely cleared from the gastrointestinal tract before this test is performed.
- See Client and Family Teaching.
Procedure
- A plain film of the kidneys is taken.
- Contrast medium is injected intravenously, the first half in 5 minutes (rapid phase) and the next half in 10 minutes (slow phase).
- Serial tomograms are initiated as soon as the slow phase begins.
- The procedure takes 1 hour.
Postprocedure Care
- Monitor vital signs and urinary output every 4 hours for 24 hours.
Client and Family Teaching
- Fast from food and fluids for 8 hours before the procedure.
- Be alert for an allergic reaction to the dye for 24 hours (itching, hives, shortness of breath, hypotension). Call the physician immediately if these symptoms occur or go to the nearest emergency department.
Factors That Affect Results
- Residual barium interferes with visualization.
Other Data
- Perform this procedure with caution on individuals who have severe cardiovascular disease, multiple myeloma, asthma, pheochromocytoma, or myasthenia gravis.
- This test is routinely performed with an intravenous pyelogram (IVP).
- See also Intravenous pyelography (IVP, excretory urography).
