30 year old male presents for IVP. Develops SOB, urticaria, drop in blood pressure

Shock Kidney
 

• Findings: One minute film demonstrates normal kidneys. Ten minute film demonstrates persistently dense nephrograms with regression and disappearance of the pyelogram phase
• Almost always seen in association with a severe adverse reaction to the administration of contrast. Hypotension leads to (and hypotension from any cause can cause this appearance)
• When arterial perfusion pressure to the kidneys drops below the minimum level required for glomerular filtration, tubular stasis occurs. Any contrast that has been excreted into the kidney stagnates
• Once Shock Kidney develops, Nephrographic desity will persist and become progressively denser. The most dramatic finding is regression or disappearance of the pyelogram phase. These findings indicate a potentially life threatening hypotension as a result of contrast reaction