What is the role of pyelography in the workup for chronic kidney disease (CKD) in children?

Updated: Jul 21, 2020
  • Author: Sanjeev Gulati, MD, MBBS, DNB(Peds), DM, DNB(Neph), FIPN(Australia), FICN, FRCPC(Canada); Chief Editor: Craig B Langman, MD  more...
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Answer

Antegrade or retrograde pyelography may be used to better diagnose and relieve urinary tract obstruction; however, the use of pyelography for the diagnosis of obstruction has largely been supplanted by ultrasonography and computed tomography (CT) scanning. Nonetheless, antegrade or retrograde pyelography may be indicated when the clinical history is highly suggestive (unexplained acute renal failure with a bland urine sediment in a patient with known pelvic malignancy) despite ultrasonography and CT scanning findings being negative for hydronephrosis (because of possible ureteral encasement). Consultation with a pediatric urologist is suggested if antegrade or retrograde pyelography is considered.


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