(Venogram-Renal, Renal Venography, Venogram of the Kidneys)
A renal venogram is a diagnostic procedure that provides information about the circulatory health of the kidneys. A renal venogram uses X-rays and intravenous (IV) contrast dye to visualize the veins within the kidneys and the veins carrying blood away from the kidneys. Contrast dye causes the blood vessels to appear opaque on the X-ray image, allowing the doctor to visualize the blood vessels being evaluated.
Fluoroscopy is often used during a renal venogram. Fluoroscopy is a study of moving body structures similar to an X-ray "movie." A continuous X-ray beam is passed through the body part being examined, and is transmitted to a TV-like monitor so that the body part and its motion can be seen in detail.
In addition to evaluating the renal veins, hypertension (high blood pressure) may be assessed during a renal venogram. A blood sample (renin assay) is obtained from each renal vein. The level of renin in the blood may help the doctor determine the cause of hypertension.
X-rays use invisible electromagnetic energy beams to produce images of internal tissues, bones, and organs on film. X-rays are made by using external radiation to produce images of the body, its organs, and other internal structures for diagnostic purposes. X-rays pass through body structures onto specially-treated plates (similar to camera film) and a "negative" type picture is made (the more solid a structure is, the whiter it appears on the film).
Other related procedures that may be used to diagnose problems of the kidneys' blood flow include computed tomography (CT scan) of the kidneys, renal ultrasound, renal angiogram, and pyelogram (intravenous, antegrade, and retrograde). Please see these procedures for additional information.
The body takes nutrients from food and converts them to energy. After the body has taken the food that it needs, waste products are left behind in the bowel and in the blood.
The kidneys and urinary system keep chemicals, such as potassium and sodium, and water in balance, and remove a type of waste, called urea, from the blood. Urea is produced when foods containing protein, such as meat, poultry, and certain vegetables, are broken down in the body. Urea is carried in the bloodstream to the kidneys.
Two kidneys, a pair of purplish-brown organs, are located below the ribs toward the middle of the back. Their function is to:
The kidneys remove urea from the blood through tiny filtering units called nephrons. Each nephron consists of a ball formed of small blood capillaries, called a glomerulus, and a small tube called a renal tubule.
Urea, together with water and other waste substances, forms the urine as it passes through the nephrons and down the renal tubules of the kidney.
The veins in a healthy kidney are free from obstruction, clots, or high blood pressure (hypertension). Some medical conditions may impede blood flow through the kidneys or cause increased blood pressure to the kidneys. If a problem with the veins of the kidney is suspected, your doctor may request a renal venogram to determine the cause of the problem.
A venogram can detect conditions stemming from the renal vein itself, as well as other problems that result from influences on the renal vein from other organs such as the kidneys. Problems involving renal circulation include structural problems that can lead to a blockage of blood flow to or from the kidneys.
Problems involving the renal circulatory system may include, but are not limited to, the following:
There may be other reasons for your doctor to recommend a renal venogram.
You may want to ask your doctor about the amount of radiation used during the procedure and the risks related to your particular situation. It is a good idea to keep a record of your past history of radiation exposure, such as previous scans and other types of X-rays, so that you can inform your doctor. Risks associated with radiation exposure may be related to the cumulative number of X-ray examinations and/or treatments over a long period of time.
If you are pregnant or suspect that you may be pregnant, you should notify your health care provider. Radiation exposure during pregnancy may lead to birth defects.
Because contrast dye is used, there is a risk for allergic reaction to the dye. Patients who are allergic to or sensitive to medications, contrast dye, or iodine should notify their doctor.
Patients with kidney failure or other kidney problems should notify their doctor. In some cases, the contrast dye can cause kidney failure, especially if the person is taking Glucophage (a diabetic medication).
Because the procedure involves the blood vessels and blood flow of the kidneys, there is a small risk for complications involving the kidneys. These complications may include, but are not limited to, the following:
Renal venography is contraindicated for patients with severe thrombosis of the inferior vena cava (the large vein that brings unoxygenated blood from the lower body to the heart) or the renal vein.
There may be other risks depending on your specific medical condition. Be sure to discuss any concerns with your doctor prior to the procedure.
Certain factors or conditions may interfere with the accuracy of a renal venogram. These factors include, but are not limited to, the following:
A renal venogram may be performed on an outpatient basis or as part of your stay in the hospital. Procedures may vary depending on your condition and your and your doctor's practices.
Generally, a renal venogram follows this process:
After the procedure, you will be taken to the recovery room for observation. You will remain flat in bed for two hours or longer. The circulation and sensation of the affected leg will be monitored. The dressing on your groin will be checked for bleeding. Once your blood pressure, pulse, and breathing are stable and you are alert, you will be taken to your hospital room or discharged to your home.
You may be given pain medication for pain or discomfort related to the injection site or to having to lie flat and still for a prolonged period.
Once you are home, monitor the groin site for bleeding or other discharge, unusual pain, swelling, and abnormal discoloration or temperature change at or near the site. A small bruise is normal, as is an occasional drop of blood at the site. If you notice a constant or large amount of blood at the site that cannot be contained with a small dressing, notify your doctor.
Monitor the leg for changes in temperature or color, pain, numbness, tingling, or loss of function of the limb.
Drink plenty of fluids to prevent dehydration and to help pass the contrast dye.
You may be advised not to do any strenuous activities or take a hot bath or shower for a period of time after the procedure.
Notify your doctor to report any of the following:
Your doctor may give you additional or alternate instructions after the procedure, depending on your particular situation.
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