Contrast Medium-Induced Nephropathy

Thomsen, Henrik S.; Stacul, Fulvio; Webb, Judith A. W.

doi:10.1007/174_2013_902

Cited by 9 publications

(10 citation statements)

References 209 publications

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“…The result of this study showed that there was no significant difference (p > 0.05) in the concentration of creatinine in the serum of diabetic groups compared to non-diabetic and dietary diabetic control groups (Table 2). This is in agreement with the findings of Stefan et al (2004) and Thomsen et al (2014), that creatinine is not a reliable biomarker in determining early damage to the kidney as it does not give an optimum expression of renal function [18,19]. However, the levels of urea increased significantly (p < 0.05) in the diabetic groups using metformin; metformin and glimepiride; metformin and glibenclamide.…”

Section: Discussionsupporting

confidence: 91%

Assessment of Toxicological Effects of Selected Popular Antidiabetic Drugs in Type II Diabetes Mellitus within Ota, Ogun State, Nigeria

Olujoke

Grace

Ebenezer

et al. 2019

JPRI

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Aim: The complications associated with diabetes and the new trend of using combination therapy in the management of the disease gave birth to this work, aimed at assessing the hepatotoxic and nephrotoxic effects of selected popularly used antidiabetic medications in type 2 diabetic patients within Ota, Ogun State, Nigeria. Study Design: The participants, diabetic (n=195) and non-diabetic (n=30) were divided into the following groups based on their medications: 1 (Non Diabetic control), 2 (Metformin), 3 (Glimepiride), 4 (Glibenclamide), 5 (Metformin and Glimepiride), 6 (Meformin and Glibenclamide), 7 (Metformin, Glimepiride and Glibenclamide) and 8 (Diabetic Dietary control). Methodology: Serum protein expression profiling, liver and kidney function parameters were assessed in participant’s blood using Sodium dodecyl sulphate polyacrylamide gel electrophoresis (SDS-PAGE) and standard laboratory methods respectively. Results: Glyceamic control within the diabetic groups was 29.23%. Urea concentration was significantly increased (p < 0.05) in groups 5 and 7 compared with groups 1 and 8 while the serum creatinine levels in the different groups showed no significant difference. Activities of alkaline phosphatase and aspartate aminotransferase increased significantly (p < 0.05) in group 5 compared with groups 1 and 8. A low molecular weight protein likely to be Leptin (molecular weight 18 kDa) was over-expressed in all the diabetic groups. Conclusion: This study shows that use of multiple rather than single drugs caused significant functional changes in the liver and kidney. The control of diabetes may best be carried out with dietary control and lifestyle modification as well as good therapeutic drug monitoring for safe assessment of baseline organ function.

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Section: Discussionsupporting

confidence: 91%

Assessment of Toxicological Effects of Selected Popular Antidiabetic Drugs in Type II Diabetes Mellitus within Ota, Ogun State, Nigeria

Olujoke

Grace

Ebenezer

et al. 2019

JPRI

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“…Apart from serious allergoid or anaphylactoid reactions, which can occur after administration of only small amounts of any CM, 76 the most relevant side effect of iodinated CM which possibly has a correlation with dose is contrast-induced nephropathy, 77 more recently referred to as contrast-induced acute kidney injury. Although the existence of contrast-induced nephropathy/contrast-induced acute kidney injury in contrast-enhanced CT is currently a matter of debate, 78 – 84 patients with renal impairment or an elevated risk of renal impairment are nevertheless still likely to benefit most from a reduction of contrast dose.…”

Section: Safety and Tolerability Aspects Of Iodinated Contrast Adminimentioning

confidence: 99%

“…Although the existence of contrast-induced nephropathy/contrast-induced acute kidney injury in contrast-enhanced CT is currently a matter of debate, 78 – 84 patients with renal impairment or an elevated risk of renal impairment are nevertheless still likely to benefit most from a reduction of contrast dose. 77 …”

Section: Safety and Tolerability Aspects Of Iodinated Contrast Adminimentioning

confidence: 99%

Low radiation dose in computed tomography: the role of iodine

Aschoff

Catalano

Kirchin

et al. 2017

BJR

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Recent approaches to reducing radiation exposure during CT examinations typically utilize automated dose modulation strategies on the basis of lower tube voltage combined with iterative reconstruction and other dose-saving techniques. Less clearly appreciated is the potentially substantial role that iodinated contrast media (CM) can play in low-radiation-dose CT examinations. Herein we discuss the role of iodinated CM in low-radiation-dose examinations and describe approaches for the optimization of CM administration protocols to further reduce radiation dose and/or CM dose while maintaining image quality for accurate diagnosis. Similar to the higher iodine attenuation obtained at low-tube-voltage settings, high-iodine-signal protocols may permit radiation dose reduction by permitting a lowering of mAs while maintaining the signal-to-noise ratio. This is particularly feasible in first pass examinations where high iodine signal can be achieved by injecting iodine more rapidly. The combination of low kV and IR can also be used to reduce the iodine dose. Here, in optimum contrast injection protocols, the volume of CM administered rather than the iodine concentration should be reduced, since with high-iodine-concentration CM further reductions of iodine dose are achievable for modern first pass examinations. Moreover, higher concentrations of CM more readily allow reductions of both flow rate and volume, thereby improving the tolerability of contrast administration.

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“…Therefore, the prevalence in this group of patients, particularly those with a glomerular filtration rate below 20 mL/ min 1.73m 2 , is not based on evidence but best estimates. It is probably somewhere in the range of 10-15% (12). This figure is important when one compares gadolinium-and iodine-based contrast media as the risk of CIN after iodine-based contrast media must be compared to the risk of nephrogenic systemic fibrosis (see below), as the opposite is not clinically relevant (iodine-based contrast media do not cause nephrogenic systemic fibrosis, and contrast mediuminduced nephropathy after gadolinium-based contrast media is extremely rare).…”

Section: Contrast-induced Nephropathymentioning

confidence: 99%

Gadolinium- or iodine-based contrast media: which choice?

Thomsen

2014

Acta Radiol

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Contrast Medium-Induced Nephropathy

Cited by 9 publications

References 209 publications

Assessment of Toxicological Effects of Selected Popular Antidiabetic Drugs in Type II Diabetes Mellitus within Ota, Ogun State, Nigeria

Assessment of Toxicological Effects of Selected Popular Antidiabetic Drugs in Type II Diabetes Mellitus within Ota, Ogun State, Nigeria

Low radiation dose in computed tomography: the role of iodine

Gadolinium- or iodine-based contrast media: which choice?

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