Contrast media. Myeloma protein precipitates in urography

IN 1939, Holman1described a patient with multiple myeloma in whom renal failure developed following pyelography. It is not clear from this report whether the pyelography was of the retrograde or intravenous type, and renal failure did not occur until 8 to 12 days after the contrast study. While this case does not represent a bona fide instance of renal failure in multiple myeloma consequent to pyelography, it nevertheless alerted subsequent observers to the potential hazards of these procedures in such patients. What appears to be the first genuine case of acute renal failure following intravenous pyelography in a patient with myelomatosis was recorded by Bartels et al2in 1954. The contrast material utilized here was iodopyracet (Diodrast). Since that time, 14 additional cases have been recorded.3-11Of the 15 cases cited, 13 had intravenous pyelography and 2 had retrograde pyelography. Eight studies were carried out with