Drawbacks

• Requires intravenous access

• Requires contrast (see below for Contrast-related adverse effects)

• Use of radiation

• Dependant on renal function (images poor if serum creatinine >200 |imol/L)

• May miss renal masses if not in line of renal contour

• Unable to distinguish between solid and cystic renal masses

• Cannot provide accurate estimation of renal function

Intravenous contrast media and the kidneys

IVU requires the administration of contrast media (CM), which possess intrinsic toxicity. The media may be—

• High-osmolar contrast media (HOCM) or

The toxicity of CM is a function of its osmolarity, chemical structure (chemotoxicity), and lipophilicity. The toxic effects may be chemotoxic (affect any organ system) or be idiosyncratic (anaphylactoid). A review of the potential widespread adverse effects of CM is not within the scope of this section; therefore, only nephrotoxic changes will be addressed in the table below (Table 3.1).

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