Nephrotoxicity from angiographic contrast material

D’Elia, John A.; Gleason, Ray E.; Alday, M.; Malarick, Charlene; Godley, Keith; Warram, James H.; Kaldany, A; Weinrauch, Larry A.

doi:10.1016/0002-9343(82)90536-8

Cited by 193 publications

(13 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…have not shown a direct relation between the volume of iodinated contrast material delivered and the risk ofARD [2,3,13]. In our series, a direct significant relation was shown between the volume of contrast material received and the risk of ARD in the entire group and in those with prior normal renal function.…”

Section: Earlier Studiescontrasting

confidence: 68%

See 1 more Smart Citation

Acute renal dysfunction after major arteriography

Gomes¹,

Baker²,

Martín‐Paredero³

et al. 1985

American Journal of Roentgenology

106

View full text Add to dashboard Cite

The incidence of acute renal dysfunction (ARD) after major arteriography was evaluated by assessment of the change in serum creatinine in 364 patients undergoing arteriography.Major arteriography was defined as abdominal aortography, abdominal aortography with lower-extremity runoft, aortic arch studies, or aortic arch plus selective carotid angiography. The influence of the volume of contrast material received, hydration, and associated risk factors was evaluated. In the entire group, the frequency of postartenographic ARD was 7.1%. Although most patients recovered, 1.4% required renal dialysis. The frequency of renal dysfunction was significantly higher in patients with preexisting renal disease (14.8%), and 3.7% of these patients went on to require dialysis. In the total group and in those with normal renal function prearteriographically, the frequency of ARD was found to be related to the volume of iodinated contrast material received. Hydration before, during, and after angiography did not prevent this complication.

show abstract

Section: Earlier Studiescontrasting

confidence: 68%

“…Diabetes, dehydration, and preexisting renal disease have at various times been implicated as risk factors [2][3][4][5][6][7][8]. Determination offrequency and risk have been further complicated by the use ofvarying definitions of renal failure.…”

mentioning

confidence: 99%

Acute renal dysfunction after major arteriography

Gomes¹,

Baker²,

Martín‐Paredero³

et al. 1985

American Journal of Roentgenology

106

View full text Add to dashboard Cite

show abstract

“…The reported incidence of nephrotoxicity from CM varies greatly, ranging from less than 1% to over 70%, almost certainly the result of selection, differences in methodology, and disagreement over what constitutes renal damage [1,6,7], Major changes in renal function may not be detected by standard renal function tests [8] but when tests of high sensitivity such as assay of urinary enzymes are performed, minor degrees of renal dysfunc tion are common [4,5,[9][10][11][12][13][14][15][16][17], This study was designed to evaluate the effects of coronary angiography on renal function using both the standard renal function tests and measurement of urinary enzyme excretion. The enzymes measured were selected to reflect damage to different areas of tubular cells in the hope that we might identify the most sensitive method of detecting kidney damage; alanine aminopeptidase (AAP) and alkaline phosphatase (ALP) are located in the brush border membrane; N-acetyl-p-giucosaminidase (p-NAG) is present in the lysosomes and lactate dehydrogenase (LDH) is found in the cytoplasm of the cell.…”

Section: Introductionmentioning

confidence: 99%

Nephrotoxicity of High- and Low-Osmolality Contrast Media

Jevnikar

Finnie

Dennis

et al. 1988

Nephron

View full text Add to dashboard Cite

Nephrotoxicity of radio-opaque contrast media (CM) is generally believed to involve toxic injury of proximal tubular cells. Measurement of urinary tubular enzyme excretion has been advocated as a sensitive marker of such toxic injury. It has been claimed that the new low-osmolality or nonionic CM reduce the incidence of nephrotoxicity but this remains uncertain. We studied 23 patients with normal renal function undergoing coronary angiography; patients were randomized into three groups receiving either diatrizoate (1,800 mmol/kg H₂O), ioxaglate (600 mmol/kg H₂O) or iohexol (850 mmol/kg H₂O). Urinary excretion of a panel of enzymes increased significantly in all groups by 20 h (p < 0.05 to < 0.005). Alanine aminopeptidase excretion at 20 h was greater after the administration of high osmolality ionic CM than with the others but all three CM produced a similar pattern of enzyme excretion. No significant change in glomerular filtration rate was found in any group so the significance of the enzymuria remains uncertain.

show abstract

“…We experienced diffi culty in attempting to compare studies of contrast-mediainduced nephropathy from different laboratories; crite ria used to diagnose renal insufficiency varied consider ably from study to study. Based on an analysis of a large distribution curve of creatinine concentrations in a hos pital population, D'Elia et al [19] suggested the use of an increase of 1.0 mg/dl in the postcontrast media serum creatinine level as an appropriate criterion for acute renal damage. No specific confirmatory pattern of urine vol- ume or urine sediment findings has been associated with radiocontrast-media-induced injury [20].…”

Section: Discussionmentioning

confidence: 99%

Uninephrectomy Does Not Potentiate Contrast Media Nephrotoxicity in the Streptozotocin-Induced Diabetic Rat

Shyh

Friedman

1990

Nephron

View full text Add to dashboard Cite

We studied the effect of radiographic contrast media on renal function in both streptozotocin-induced diabetic rats and normoglycemic rats with reduced renal functional mass. Male Sprague-Dawley induced-diabetic rats and weight-matched controls were divided into unilaterally nephrectomized and intact groups prior to an intravenous challenge with sodium diatrizoate (Urografin) at two dose levels, 1,300 and 2,600 mg iodine/kg. Serum creatinine concentration did not change on the 1st and 3rd day after a dose of 1,300 mg/kg of iodine in normal or induced-diabetic rats. Consequent to a dose of 2,600 mg/kg of iodine, induced-diabetic rats had a significant increase in serum creatinine levels to 0.9 ± 0.45 mg/dl (control 0.68 ± 0.11 mg/dl). The observed increase in serum creatinine concentration after treatment with sodium diatrizoate was significantly correlated with the degree of hyperglycemia, but not with prior unilateral nephrectomy. Unilateral nephrectomy, prior to administration of sodium diatrizoate did not potentiate the risk of radiocontrast agent injury in induced-diabetic rats. From these findings, we infer that: (1) streptozotocin-induced diabetes in the rat confers a risk for the development of radiocontrast-induced acute renal failure and (2) as judged by the rise in serum creatinine concentration after exposure, there is an increased risk of acute renal failure associated with a higher dose of radiocontrast material.

show abstract

Nephrotoxicity from angiographic contrast material

Cited by 193 publications

References 25 publications

Acute renal dysfunction after major arteriography

Acute renal dysfunction after major arteriography

Nephrotoxicity of High- and Low-Osmolality Contrast Media

Uninephrectomy Does Not Potentiate Contrast Media Nephrotoxicity in the Streptozotocin-Induced Diabetic Rat

Contact Info

Product

Resources

About