Cytotoxic Effects of Ionic High-osmolar, Nonionic Monomeric, and Nonionic Iso-osmolar Dimeric Iodinated Contrast Media on Renal Tubular Cells in Vitro

Heinrich, Marc; Kuhlmann, Martin K.; Grgic, Aleksandar; Heckmann, Martina; Kramann, B.; Uder, Michael

doi:10.1148/radiol.2353040726

Cited by 150 publications

(99 citation statements)

References 45 publications

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“…(D) (C) studies, 21,22 and also on the fact that ICM are concentrated in the kidneys compared with blood plasma. Urinary concentrations of ICM can be up to 50-100 times that in plasma.…”

Section: Discussionmentioning

confidence: 99%

“…Heinrich et al 21 compared different contrast media with the MTT assay, and when ICM were compared at equal iodine concentrations (75 mg I/mL), they found that dimeric contrast media showed a slightly weaker effect on inhibition of mitochondrial dehydrogenases than monomers, but this difference was not statistically significant. In the same study, the contrast media were also compared at molar basis and it was shown that dimeric ICM were significantly more cytotoxic than monomers on cultured renal cells.…”

Section: Discussionmentioning

confidence: 99%

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The Effects of the Iodinated X-Ray Contrast Media Iodixanol, Iohexol, Iopromide, and Ioversol on the Rat Kidney Epithelial Cell Line NRK 52-E

et al. 2011

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Nephrotoxicity, associated with the administration of iodinated X-ray contrast media (ICM), continues to be a major side effect in a significant number of vulnerable patients undergoing diagnostic X-ray imaging procedures. The molecular mechanisms underlying these adverse effects on the kidneys are unclear despite several decades of investigation. Side effects are more common after exposure to high-osmolar compared with low-osmolar ICM, suggesting that osmolality may be an important physical-chemical property related to nephrotoxicity. This investigation in cultured NRK 52-E cells, a cell line of renal origin, compares the in vitro toxicity of the iso-osmolal ICM iodixanol with the lowosmolal ICM iohexol, iopromide, and ioversol. The cellular toxicity was evaluated with the trypan blue exclusion assay, the MTT assay, and incidences of cell death. A qualitative assessment of vacuolation of the cultured NRK 52-E cells was taken as a measure of intracellular uptake of ICM. A difference in cell death incidence was observed between the iso-osmolal iodixanol and the low-osmolal iohexol, iopromide, and ioversol contrast media, with the isoosmolal iodixanol having the least effect in each of the in vitro systems tested. The osmolality of the contrast media appeared to be the major cause for the observed in vitro toxicity.

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“…(D) (C) studies, 21,22 and also on the fact that ICM are concentrated in the kidneys compared with blood plasma. Urinary concentrations of ICM can be up to 50-100 times that in plasma.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

The Effects of the Iodinated X-Ray Contrast Media Iodixanol, Iohexol, Iopromide, and Ioversol on the Rat Kidney Epithelial Cell Line NRK 52-E

et al. 2011

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“…Thus, it cannot be excluded that gadodiamide also exerts a chemotoxic effect. Such effects may include non-osmolality dependent release of vasoconstrictors such as endothelin [12] and direct cytotoxic effects on tubular cells [35][36][37].…”

Section: Discussionmentioning

confidence: 99%

Gadolinium contrast media are more nephrotoxic than iodine media. The importance of osmolality in direct renal artery injections

et al. 2006

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“…This early diuresis is essential and allows limiting the contact time of the contrast product with the nephrons, which is the main physiopathological mechanism of nephrotoxicity. PCI stasis in the renal tubular lumen is responsible for direct cell damage [20]. The degree of renal tubular cytotoxicity is directly related to the duration of exposure of these cells to the iodinated contrast agent.…”

Section: Discussionmentioning

confidence: 99%

Implications of Renal Complications In Out Patient Referral for Coronary Angiography: Prospective Observational Study of 98 Cases

Js¹,

Payot²,

Zabalawi³

et al. 2017

J Clin Exp Cardiolog

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The incidence of acute kidney failure remains high, due to the multiplication of interventional procedures on subjects at risk. It increases both morbi-mortality in hospitals and in the long term. The identification of patients atriskis primordial in order to implement the preventiv emeasures, whose expansion remains the 'gold standard'. The realization of a coronary angiography in ambulatory care in this type of patient at risk is possible without increasing renal morbidity, under the cover of a good hydration.Introduction: Acute renal failure is a complication that remains common after injection of contrast agent. It increases both morbidity and hospital mortality in the long term. We wanted to carry out a prospective observational study to evaluate the incidence of renal complications (acute renal failure, dialysis) of patients referred as an outpatient in our center for coronary angiography and who have benefited from measures of prevention of renal toxicity as recommended by learned societies. Methodology:We conducted a prospective study at the Yves Le Foll hospital in Saint Brieuc over a period of 4 months from November 2015 to February 2016, in patients admitted on an outpatient basis for coronary angiography who had previously suspended all drugs with nephrotoxic potential and with hydration surrounding the examination. A survey card was developed to collect, after informed consent, sociodemographic data, risk factors, comorbidities, clinical and paraclinical data. All data was entered and analyzed using SPSS software version 18.0.Results: Ninety-eight patients had an ambulatory coronary angiogram during this period. The sex ratio was 3.66 in favor of the male genus with an average age of 65 years. Three-quarters of the population (71%) had at least one risk factor for contrast-induced nephropathy. The mean clearance values before and after coronary angiography were almost similar (80 μmol/l) without significant variation. No impairment of renal function was observed in patients at risk regardless of the amount of contrast injected (range: between 30 and 277 ml). When patients accumulate risk factors for induced nephropathy in the contrast medium, there is an increase in the blood creatinine level with the number of factors but no significant change (p: 0.24) of renal function after iodine injection. Conclusion:The incidence of acute kidney injury remains high, due to the increase of intervention procedures in subjects at risk. The identification of these patients at risk is paramount in order to implement the preventive measures of which volume expansion remains the gold standard. The realization of an outpatient coronary angiography in this type of patient at risk is feasible without increasing renal morbidity with a good hydration.

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Cytotoxic Effects of Ionic High-osmolar, Nonionic Monomeric, and Nonionic Iso-osmolar Dimeric Iodinated Contrast Media on Renal Tubular Cells in Vitro

Cited by 150 publications

References 45 publications

The Effects of the Iodinated X-Ray Contrast Media Iodixanol, Iohexol, Iopromide, and Ioversol on the Rat Kidney Epithelial Cell Line NRK 52-E

The Effects of the Iodinated X-Ray Contrast Media Iodixanol, Iohexol, Iopromide, and Ioversol on the Rat Kidney Epithelial Cell Line NRK 52-E

Gadolinium contrast media are more nephrotoxic than iodine media. The importance of osmolality in direct renal artery injections

Implications of Renal Complications In Out Patient Referral for Coronary Angiography: Prospective Observational Study of 98 Cases

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