Contrast agents available in North America for excretory urography are combinations of sodium and/or meglumine salts of diatrizoate and iothalamate in 50% to 60% solutions (Conray-60, Hypaque Meglumine 60%, Reno-M-60, Renografin-60, and Hypaque Sodium 50%). There is no substantive reason for choosing between these various iodinated contrast agents: packaging, pricing, and quality control are the determinants for their selection. Because of their high osmolarity, the intravenous injection of Renografin-60 (1,400 mOsm/ liter) and Hypaque Sodium 50% (1,170 mOsm/ liter) may result in profound changes in the hemostatic mechanisms of small infants. Blood samples of infants obtained at regular intervals after an injection of 5 ml/kg of Renografin-60 disclosed changes in serum osmolarity, serum sodium levels, and hematocrit values. The mean increase in serum osmolarity three minutes after injection was 15 mOsm/liter, or a 5.3% increase. Hematocrit values decreased by a mean of 7.4%, and the serum sodium concentrations fell by a mean of 4.6 mEq/liter. These values gradually returned to normal in one to four hours.1 Acute expansion of blood volume after the intr
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