RENAL ANGIOGRAPHY IN PATIENTS WITH HEMATURIA

A retrospective study was carried out on 120 patients with hematuria, in 100 of whom angiography was performed after normal urographic findings, and in the remaining 20 after slight, unspecific urographic changes, which did not explain the cause of the bleeding.

The investigation shows that the diagnostic value of angiography in early stages of glomerulonephritis, pyelonephritis and interstitial nephritis is limited. If casehistory, other roentgenologic examinations and laboratory findings suggest one of these diagnoses, there is no indication for angiography, and renal biopsy should be performed.

In all cases with a suspected tumor at urography, angiography should be performed.

In this investigation there were 19 patients with renal vascular changes which could be the cause of hematuria. Angiography was the main diagnostic method. The frequency of such changes appears to be greater than has been hitherto observed. Some of the hemangiomas are so minute that they cannot be observed at angiography, but might be detected by flow studies. A follow-up of 32 patients with initially essential hematuria has revealed 2 cases with calculus, 4 with glomerulonephritis and 1 with interstitial nephritis, but no malignancy, as opposed to observations in other reports, where angiography was not performed.

Vascular changes and tumors are frequent enough to make angiography a necessary procedure, but in instances where the urographic studies appear normal, it should be postponed until other clinical methods have failed to yield any diagnostic clue.

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