Health Encyclopedia

Intravenous Pyelogram

What is an intravenous pyelogram?

An intravenous pyelogram is an imaging test used to look at the kidneys and ureters. The ureters are the narrow tubes that carry urine from the kidneys to the bladder.

During the test, the radiologist injects a contrast dye into one of your veins. He or she uses X-ray images to watch the contrast dye as it moves from the kidney into the ureter and then to the bladder.

Dye that moves too slowly or not at all may mean that you have a blockage in the blood flow through a kidney. It may also mean that a kidney is not working as well as it should.

This test is usually one of the first tests ordered when your healthcare provider thinks you may have kidney disease or a urinary tract problem.

X-rays use a small amount of radiation to create images of your bones and internal organs. X-rays are most often used to detect bone or joint problems, or to check the heart and lungs. An intravenous pyelogram is one type of X-ray.

This test may be done at the same time as a CT scan of the kidneys (nephrotomography). The CT scan also uses contrast dye. But it makes images that show layers or “slices” of the kidney.

Today CT and MRI scans and ultrasound are often used instead of an intravenous pyelogram.

Why might I need an intravenous pyelogram?

An intravenous pyelogram can show your healthcare provider the size, shape, and structure of your kidneys, ureters, and bladder. You may need this test if your provider suspects that you have:

  • Kidney disease
  • Ureter or bladder stones
  • Enlarged prostate
  • Trauma or injury to the urinary tract
  • Tumors

Your provider may also use this test to find the cause of flank pain or pain spasms in the kidney area.

A CT scan of the kidneys can help make a more accurate diagnosis of kidney tumors or kidney problems caused by trauma.

Your healthcare provider may have other reasons to recommend an antegrade pyelogram.

What are the risks of an intravenous pyelogram?

You may want to ask your healthcare provider about the amount of radiation used during the test. Also ask about the risks as they apply to you.

Consider writing down all X-rays you get, including past scans and X-rays for other health reasons. Show this list to your provider. The risks of radiation exposure may be tied to the number of X-rays you have and the X-ray treatments you have over time.

Tell your healthcare provider if you:

  • Are pregnant or think you may be pregnant. Radiation exposure during pregnancy may lead to birth defects.
  • Are allergic to or sensitive to any medicines, contrast dye, or iodine. Because contrast dye is used, there is a risk for allergic reaction to the dye.
  • Have kidney failure or other kidney problems. In some cases the contrast dye can cause kidney failure. You are at higher risk for this if you take certain diabetes medicines.

Possible complications of this test also include problems urinating and urinary tract infections.

You may have other risks depending on your specific health condition. Be sure to talk with your provider about any concerns you have before the procedure.

Certain things can make this test less accurate. These include:

  • You have feces or gas in your colon
  • You have poor blood flow to the kidneys
  • You have barium in your intestines from a recent barium test

How do I get ready for an intravenous pyelogram?

  • Your healthcare provider will explain the procedure to you. Ask him or her any questions you have about the procedure.
  • You may be asked to sign a consent form that gives permission to do the procedure. Read the form carefully and ask questions if anything is not clear.
  • You'll be asked to not eat or drink liquids (fast) before the procedure. Your health care provider will tell you how long to fast. It might be several hours or overnight.
  • Tell your provider if you are pregnant or think you may be pregnant.
  • Tell your healthcare provider if you are allergic to contrast dye or iodine.
  • Tell your healthcare provider if you are sensitive to or are allergic to any medicines, latex, tape, or anesthetic drugs (local and general).
  • Tell your provider about all medicines you are taking. This includes prescriptions, over-the-counter medicines, and herbal supplements. If you have diabetes and take metformin, you may need to stop taking this medicine.
  • Tell your healthcare provider if you have had a bleeding disorder. Also tell your provider if you are taking blood-thinning medicine (anticoagulant), aspirin, or other medicines that affect blood clotting. You may need to stop these medications before the test.
  • You need to take a laxative the night before the test and have a cleansing enema or suppository a few hours before the test.
  • You may need to have a blood test to see how well your kidneys will react to the contrast dye.
  • Follow any other instructions your provider gives you to get ready.

What happens during an intravenous pyelogram?

You may have an intravenous pyelogram as an outpatient or as part of your stay in a hospital. The way the test is done may vary depending on your condition and your healthcare provider's practices.

Generally, an IVP follows this process:

  1. You will be asked to remove any clothing, jewelry, or other objects that may get in the way of the test.
  2. You may be asked to remove clothing. If so, you will be given a gown to wear.
  3. An intravenous (IV) line will be inserted in your hand or arm.
  4. You will be asked to lie face up on an X-ray table.
  5. The radiologist will take an X-ray of your kidneys, ureters, and bladder.
  6. The radiologist will inject the contrast dye into the IV. You may feel a flushing sensation, a salty or metallic taste in your mouth, a brief headache, itching, or nausea or vomiting. These effects usually last for a few moments.
  7. The radiologist will take a series of X-rays as the dye travels through the kidneys and urinary tract. This usually lasts about 30 minutes. You may be asked to change positions while the X-rays are taken.
  8. You will be asked to empty your bladder. You may be given a bedpan or urinal. Or you may be allowed to use the restroom.
  9. After you have emptied your bladder, the radiologist will take a final X-ray to see how much contrast dye remains in the bladder.

What happens after an intravenous pyelogram?

You do not need any special care after an intravenous pyelogram. You may go back to your usual diet and activities, unless your healthcare provider tells you differently.

You should keep track of how much fluid you are drinking and how urine you pass over the next day (24 hours). You may be told to drink more fluids to help flush the contrast dye from your body.

Call your healthcare provider right away if any of these occur:

  • Fever or chills
  • Redness, swelling, or bleeding or other drainage from the IV site
  • Blood in your urine
  • Nausea, itching, or sneezing

Your healthcare provider may give you other instructions, depending on your situation.

Next steps

Before you agree to the test or the procedure make sure you know:
  • The name of the test or procedure
  • The reason you are having the test or procedure
  • The risks and benefits of the test or procedure
  • When and where you are to have the test or procedure and who will do it
  • When and how will you get the results
  • How much will you have to pay for the test or procedure

Medical Reviewers:

  • MMI board-certified, academically affiliated clinician
  • Moloney Johns, Amanda, PA-C, MPAS, BBA