What is a renal arteriogram?

A renal arteriogram is a special type of X-ray picture that helps doctors see the blood vessels in your kidneys. This exam is used for patients who have high blood pressure that may be caused by a kidney problem. It is also helpful in patients who may have a kidney artery that is closed or whose arteries are inflamed.

How is it done?

This procedure is performed by a radiologist who is assisted by specially trained nurses and technologists. Using a needle, the doctor inserts a thin wire into a large artery in the groin area. This wire is used to guide a small tube called a catheter into the large artery leading to your kidneys. Once the catheter is in place, the X-ray dye is injected through the catheter, and X-rays are taken of the arteries.

What is a renal angioplasty?

Renal angioplasty is a procedure done to improve blood flow to the kidney. A balloon catheter is inserted through an artery (usually through the femoral artery in the groin area) and passed through your bloodstream to the narrowed artery in the kidney. The balloon is inflated and it redistributes the fat deposits within the inner walls of the artery, improving the blood flow.

What is a renal stent?

Percutaneous Transluminal Angioplasty is a procedure done to improve blood flow to a blocked artery. A balloon catheter is inserted into the blockage and inflated to compress the fat deposits within the inner wall, thereby improving blood flow. At times, reclosure can occur. To offset this possibility, the stent was developed. The stent is a tiny coiled wire or mesh that is permanently placed at the angioplasty site to maintain the new opening. This is often done after a recent blocked artery.

Renal venous sampling

Renal venous sampling is measurement of the renal renin secretion by selective sampling of renal vein blood. The test is used to select hypertensive patients with renal artery bockages who would profit from renal artery dilation or surgery.

Percutaneous nephrostomy tube placement

Percutaneous nephrostomy or nephropyelostomy is an interventional procedure used mainly to open a blocked kidney waste collection system. Since a report of the first series involving this procedure in 1955, percutaneous nephrostomy catheter placement has been the prime procedure for the temporary drainage of an obstructed collecting system.
The main reason that percutaneous nephrostomy tubes are placed is for temporary urinary diversion due to urinary obstruction secondary to calculi. Other common indications include the following:

• Diversion of urine from the renal collecting system in an attempt to heal fistulas or leaks due to traumatic or iatrogenic injury, malignant or inflammatory fistulas, or hemorrhagic cystitis
• Treatment for nondilated obstructive uropathy
• Treatment for urinary tract obstruction related to pregnancy
• Treatment for complications related to renal transplants
• Access for interventions such as direct infusion of substances for dissolving stones, chemotherapy, and antibiotic or antifungal therapy
• Access for other procedures (eg, benign stricture dilatation, antegrade ureteral stent placement, stone retrieval, pyeloureteroscopy, endopyelotomy)
• Decompression of nephric or perinephric fluid collections (eg, abscesses, urinomas)

Percutaneous nephroureterostomy tube placement

Similar to a nephrostomy, but differs in that a longer tube is used and the distal end is placed in the bladder or ileal conduit to allow both internal and external drainage or urine.

Ureteral dilatation

Abnormalities of the smooth muscle of the urethra or nerve supply may cause partial or total ureteral dilation or obstruction. Prognosis depends on the integrity of nearby muscles of the ureter. Treatment is surgical.
Ureteral occlusion

Urinary fistula after treatment for cancer constitutes a dilemma for your physicians, especially in patients who have had various other treatments. Patients with urinary leakage can be treated conservatively with percutaneous transrenal balloon catheters.

If a patient has persistent urinary leakage despite treatments and catheter drainage, then further procedures may be suggested by your physician. Small Foley balloon catheters and angioplasty catheters may be used. These devices are inserted under the skin and into the affected areas.
Long-term ureteral occlusion with percutaneous transrenal balloon catheters appears to be safe. Using this approach, urinary fistula can heal in some patients without the need for open surgery.

Tract dilatation for lithotrypsy

Lithotripsy is Greek for stone breaking. Lithotripsy is a treatment used to break up kidney stones. Without entering the kidney with surgery, kidney stones can be broken up with high-energy sound waves. The fragments are then passed in the urine.

The process uses a device called a lithotriptor. One type makes sound waves, while the other type makes ultrasound (sound waves we cannot hear). These waves travel easily through the soft tissues of the body without any damage. The stones absorb the energy from these waves, and break up. Stone fragments are then passed in the urine. The treatment is not painful, but passing the stone fragments may be. Therefore the urinary tract is dilated for lithotripsy.

Kidney stones are crystal masses that form from minerals and proteins in the urine. Stones come in various sizes, and compositions. Certain types of stones will respond to this treatment better than others.

If you have kidney stones, lithotripsy may make removal fairly simple. Your recovery time will be much shorter than with surgery. However, this procedure does not alter the reasons that the stones formed. To prevent future stones follow the therapy and dietary changes that you your healthcare provider orders.