Acute Renal Failure After Intravenous Pyelography in Plasma Cell Myeloma

In 1954, Bartels and his associates¹reported a patient with plasma cell myeloma (multiple myeloma, myelomatosis) who developed acute renal failure immediately after intravenous pyelography. Three additional patients with plasma cell myeloma, in whom intravenous pyelograms appear to have precipitated oliguria or anuria, have been described in the Scandinavian literature.² Recently, we have observed this phenomenon in a patient with plasma cell myeloma in whom normal renal function was demonstrated immediately prior to pyelographic examination. Our observations of this patient have indirectly led to the recognition of pyelography-induced anuria in a woman with plasma cell myeloma.³The purpose of this communication is to focus attention on the potential danger of intravenous pyelography in patients with this disease and to discuss the pathogenesis of the acute renal failure in these patients. Report of a Case A 34-year-old man was admitted to the medical service of the West Haven