(Angiogram-Kidneys, Renal Angiography, Renal Arteriogram, Renal Arteriography)
An angiogram, also called an arteriogram, is an X-ray image of the blood vessels. It is performed to evaluate various vascular conditions, such as an aneurysm (ballooning of a blood vessel), stenosis (narrowing of a blood vessel), or blockages.
A renal angiogram is an angiogram of the blood vessels of the kidneys. A renal angiogram may be used to assess the blood flow to the kidneys.
Fluoroscopy is often used during a renal venogram. Fluoroscopy is the 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 order to obtain an X-ray image of a blood vessel, an intravenous (IV) or intra-arterial (IA) access is necessary so that a contrast dye can be injected into the body's circulatory system. This contrast dye causes the blood vessels to appear opaque on the X-ray image, thus allowing the doctor to better visualize the structure of the vessel(s) under examination.
Many arteries can be examined by an angiogram, including the arterial systems of the legs, kidneys, brain, and heart.
For a renal angiogram, arterial access may be obtained through a large artery such as the femoral artery in the groin. Once access is obtained, the contrast dye is injected and a series of X-ray pictures is made. These X-ray images show the arterial, venous, and capillary blood vessel structures and blood flow in the kidneys.
Other related procedures that may be used to diagnose kidney problems include kidney, ureters, and bladder (KUB) X-ray, computed tomography (CT scan) of the kidneys, kidney biopsy, kidney scan, kidney ultrasound, and renal venogram. 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.
A renal angiogram may be performed to detect abnormalities of the blood vessels of the kidneys. Such abnormalities may include, but are not limited to, the following:
Other conditions that may be detected by a renal angiogram include tumors, hemorrhage (bleeding), complications of kidney transplantation, and the invasion of a tumor into the blood vessels. Kidney failure and other chronic kidney diseases may be evaluated by a renal angiogram. An angiogram may be used to deliver medications directly into the tissue or organ needing treatment, such as the administration of a clotting medication to a bleeding site or cancer medication into a tumor.
A renal angiogram may be recommended after a previous procedure, such as a CT scan, indicates the need for further information.
There may be other reasons for your doctor to recommend a renal angiogram.
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.
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. Also, patients with kidney failure or other kidney problems should notify their doctor.
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:
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 angiogram. These factors include, but are not limited to, the following:
A renal angiogram may be performed on an outpatient basis or as part of your stay in a hospital. Procedures may vary depending on your condition and your doctor's practices.
Generally, a renal angiogram follows this process:
After the procedure, you will be taken to the recovery room for observation. The circulation and sensation of the leg where the injection catheter was inserted will be monitored. A nurse will monitor your vital signs and the injection site.
You will remain flat in bed in a recovery room for several hours after the procedure. If the groin or arm site was used, the leg or arm on the side of the injection site will be kept straight for up to 12 hours.
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.
You will be encouraged to drink water and other fluids to help flush the contrast dye from your body.
You may resume your usual diet and activities after the procedure, unless your doctor advises you differently.
When you have completed the recovery period, you may be returned to your hospital room or discharged to your home. If this procedure was performed as an outpatient, you should have another person drive you home.
Once at home, you should monitor the injection site for bleeding. A small bruise is normal, as is an occasional drop of blood at the site.
If the groin or arm was used, you should monitor the leg or arm 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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