Intravenous Contrast Agents and Associated Changes in Serum Osmolality

George, Mathew; Shannon, Michael P.

doi:10.1097/pec.0b013e3181b5b8ce

Cited by 6 publications

(2 citation statements)

References 13 publications

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“…One study demonstrated that contrast media does not increase plasma osmolarity or produce an osmolar gap between the time 0 and 30 minutes after contrast administration (George and Shannon 2009); their study showed no data on changes in renal function. In our study, there was no change in plasma osmolarity or plasma osmolar gap in the no-CIAKI group, which is consistent with a previous report (George and Shannon 2009). In contrast, the plasma osmolar gap at hour 6 was significantly increased in patients with CIAKI.…”

Section: Discussionsupporting

confidence: 82%

Increased Plasma Osmolar Gap Is Predictive of Contrast-Induced Acute Kidney Injury

Kim

Sung

Kang

et al. 2012

Tohoku J. Exp. Med.

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Contrast-induced acute kidney injury (CIAKI) is a common complication after percutaneous coronary artery intervention (PCI). It is urgent to find a novel, easily measurable and accurate predictor for the early detection of CIAKI. Hyperosmolarity and large amounts of contrast media are risk factors for CIAKI. However, there is no study on plasma osmolar gap as a predictor of CIAKI. We enrolled 89 patients undergoing elective PCI and tested changes of serum sodium, osmolar gap, and renal function at 0, 6, 12 and 24 hours. Plasma osmolar gap was calculated using the following formula: measured plasma osmolarity -[2(Na) + serum urea nitrogen/2.8 + glucose/18]. CIAKI was defined as follows: increase in serum creatinine of ≥ 50%, increase in serum creatinine of ≥ 0.3 mg/dL, or decrease in estimated glomerular filtration rate of ≥ 25% within 24 hours after PCI. The incidence of CIAKI was 13.5% (12/89 patients). The CIAKI group had higher plasma osmolar gaps 6 hours after PCI. The adjusted hazard ratio of the plasma osmolar gap from hour 6 (1-mOsm/L increments) to the development of CIAKI was 1.12 (95% confidence interval [CI], 1.01-1.26; P = 0.041). Sensitivity and specificity of 7 mOsm/L or higher plasma osmolar gap at hour 6 were 70.0% and 76.6%, respectively (area under the ROC curve = 0.77 [95% CI, 0.65-0.89]). Increased plasma osmolar gap may precede the development of CIAKI in patients undergoing PCI. In conclusion, plasma osmolar gap may be a useful predictor for the development of CIAKI.

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Section: Discussionsupporting

confidence: 82%

Increased Plasma Osmolar Gap Is Predictive of Contrast-Induced Acute Kidney Injury

Kim

Sung

Kang

et al. 2012

Tohoku J. Exp. Med.

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“…Theoretically speaking, OG represents the amount of serum osmotic substances other than sodium, BUN, and glucose. Usually, OG values are measured in emergency medicine, because it reflects exogenous substances in intoxicated patients (e.g., acute alcohol intoxication, drug abuse) (Dawson and Whyte 2001;Purssell et al 2001;Fenves et al 2006;Lynd et al 2008;George and Shannon 2009). However, none of these exogenous factors were suspected or confirmed in the 12 patients with polyneuropathy.…”

Section: Discussionmentioning

confidence: 99%

Abnormal Osmolality Gap Exists in Distal Symmetric Polyneuropathy

Akaishi

Takahashi

Nakashima

et al. 2018

Tohoku J. Exp. Med.

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Distal symmetric polyneuropathy, represented by chronic inflammatory demyelinating polyneuropathy, is a popular neurological condition. Some cases are known to be associated with genetic mutations or serum auto-antibodies, but the exact mechanisms in most cases are unknown. Recently, osmotic factors have been suggested to trigger some neurological disorders, such as neuromyelitis optica. The aim of the present study was to assess the possible association of osmotic factors in the pathogenesis of distal polyneuropathy. We prospectively measured the serum levels of osmolality, electrolytes, total protein, albumin, blood urea nitrogen, glucose, and osmolality gap in the patients with acute distal polyneuropathy before treatments (n = 12) and those with other comprehensive neurological disorders such as multiple sclerosis and neurodegenerative diseases (n = 176). Then, we compared each osmotic fraction between the two groups. As a result, all of the 12 patients with acute distal polyneuropathy, including 4 patients with chronic inflammatory demyelinating polyneuropathy, showed abnormally high or low values of osmolality gap, compared to the others (p < 0.0001, F-test). In the patients with other diseases, there were 2 patients with abnormally high osmolality gap values, which were attributable to their hyperlipidemia or high titer of serum autoantibody unrelated to polyneuropathy. In conclusion, serum osmolality gap would be elevated or decreased in the acute phase of distal symmetric polyneuropathy. Osmotic imbalance between the serum and nerve cells, based on abnormal excess or deficit of some unidentified serum osmolytes, may be one of the mechanisms in symmetric polyneuropathy with unknown causes.

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Current awareness: Pharmacoepidemiology and drug safety

2010

Pharmacoepidemiology and Drug

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In order to keep subscribers up‐to‐date with the latest developments in their field, John Wiley & Sons are providing a current awareness service in each issue of the journal. The bibliography contains newly published material in the field of pharmacoepidemiology and drug safety. Each bibliography is divided into 23 sections: 1 Reviews; 2 General; 3 Anti‐infective Agents; 4 Cardiovascular System Agents; 5 CNS Depressive Agents; 6 Non‐steroidal Anti‐inflammatory Agents; 7 CNS Agents; 8 Anti‐neoplastic Agents; 9 Haematological Agents; 10 Neuroregulator‐Blocking Agents; 11 Dermatological Agents; 12 Immunosuppressive Agents; 13 Autonomic Agents; 14 Respiratory System Agents; 15 Neuromuscular Agents; 16 Reproductive System Agents; 17 Gastrointestinal System Agents; 18 Anti‐inflammatory Agents ‐ Steroidal; 19 Teratogens/fetal exposure; 20 Antidiabetic Agents; 21 Contrast Agents; 22 Bone Conservation Agents; 23 Others. Within each section, articles are listed in alphabetical order with respect to author. If, in the preceding period, no publications are located relevant to any one of these headings, that section will be omitted.

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Intravenous Contrast Agents and Associated Changes in Serum Osmolality

Cited by 6 publications

References 13 publications

Increased Plasma Osmolar Gap Is Predictive of Contrast-Induced Acute Kidney Injury

Increased Plasma Osmolar Gap Is Predictive of Contrast-Induced Acute Kidney Injury

Abnormal Osmolality Gap Exists in Distal Symmetric Polyneuropathy

Current awareness: Pharmacoepidemiology and drug safety

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