RECENT reports have emphasized the risk of radiographic contrast-induced acute renal failure in diabetic nephropathy and have suggested an increasing incidence with a decreasing glomerular filtration rate.1,2An absolute contraindication to intravenous pyelography has been proposed for diabetic patients whose serum creatinine level is greater than 5 mg/dl, with a relative contraindication in the presence of any degree of azotemia.2No safe cutoff in renal function or in contrast volume has yet been established. We report what we believe to be the first mortality due to intravenous pyelographic contrast media-induced renal failure in an elderly patient whose serum creatinine level would not ordinarily be sufficient to consider him at high risk for any further renal compromise. Report of a Case A 74-year-old man was admitted to the New England Deaconess Hospital on May 6, 1977, because of an inability to walk and weight loss. His past medical history
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Larry A. Weinrauch (1978) studied this question.