Nephrotoxicity of Radiocontrast Media in Ischemic Renal Failure in Rabbits

Schultz, Stanton G.; Lavelle, Kevin J.; Swain, Richard R.

doi:10.1159/000182829

Cited by 17 publications

(8 citation statements)

References 12 publications

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“…This has been confirmed in various other ani mal models [25,26]. In our model, the transient ischemia acted essentially as an enhancing factor to reveal the CMinduced toxicity [5].…”

Section: Experimental Modelsupporting

confidence: 83%

Comparative Effects of Low- and High-Osmolar Contrast Media on the Renal Function during Early Degenerative Gentamicin-lnduced Nephropathy in Rats

Idée

Santus²,

Beaufils³

et al. 1995

Am J Nephrol

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The nephrotoxic potentials of a high-osmolar contrast medium, diatrizoate, and of a low-osmolar contrast medium, ioxaglate, were compared during early degenerative gentamicin-induced nephropathy in the rat. Male rats (13-22/group) were uninephrectomized. Six days later, the aorta was clamped above the renal artery, and either diatrizoate or ioxaglate was administered (1 ml/min for 3 min) via an aortic puncture into the remaining kidney. Some of the rats received chronic treatment with gentamicin (50 mg/kg/day i.m., 4 days), starting 2 days before and ending 1 day after contrast medium administration. Two control groups, only one of which received gentamicin, were subjected to a 3-min renal ischemia. The creatinine clearance (CrCl) per 100 g body weight was determined before and 24 and 48 h after contrast medium injection. A second study (6 rats/group) evaluated urinary N-acetyl-β-D -glucosaminidase (NAG) excretion and the histologic appearance of the kidneys (blinded analysis) in the same experimental groups. Gentamicin induced a significant decrease in CrCl at baseline(0.35 ± 0.19vs.0.41 ± 0.19 ml/min; p < 0.01) and an increase in urinary NAG(128 ± 92 vs. 39 ± 57 µmol/h/mmol creatinine; p < 0.01). Taking into account these differences at baseline, univariate repeated-measures analysis showed that on day 1 diatrizoate caused a more marked decrease in CrCl than ioxaglate (p < 0.05), whether or not gentamicin was also administered. On day 2, the depressant effect of diatrizoate associated with gentamicin persisted (CrCl vs. day 0 = -0.19 ± 0.10 ml/min), while that of diatrizoate alone returned to baseline (-0.05 ± 0.24 ml/min). Conversely, the effects of ioxaglate did not differ from those of the control groups at the two measuring times. Although the effects of contrast medium-gentamicin interaction were not significant for urinary NAG, the gentamicin plus diatrizoate combination suggested greater toxic potential than the gentamicin plus ioxaglate combination on day 2 (NAG vs. day 0 = +260 ± 528 vs. +22 ± 119 µmol/h/mmol creatinine). In contrast to ioxaglate alone, which only induced vacuolization, diatrizoate alone provoked foci of tubular necrosis associated with vascular lesions. Gentamicin alone induced irregular vacuolization. Contrary to the findings for gentamicin plus diatrizoate, no necrotic foci were observed with gentamicin plus ioxaglate. The nephrotoxic potential of diatrizoate after intra-renal administration is greater than that of ioxaglate administered in the rat during the early degenerative phase of gentamicin-induced nephropathy.

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“…This has been confirmed in various other ani mal models [25,26]. In our model, the transient ischemia acted essentially as an enhancing factor to reveal the CMinduced toxicity [5].…”

Section: Experimental Modelsupporting

confidence: 83%

Comparative Effects of Low- and High-Osmolar Contrast Media on the Renal Function during Early Degenerative Gentamicin-lnduced Nephropathy in Rats

Idée

Santus²,

Beaufils³

et al. 1995

Am J Nephrol

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“…Interestingly, other studies have previously suggested the existence of adverse interactions between renal hyp oxia and contrast agents, which are possibly necessary for the development of experimental contrast nephropa thy [5,[10][11][12][13], Two other models of contrast-media-induced acute renal failure have recently been published. Vari et al [14] have shown that a low sodium intake followed by indomethacin and contrast media lead to reversible acute renal failure in the rabbit.…”

Section: Discussionmentioning

confidence: 99%

Renal Effects of Radiocontrast Agents in Rats: A New Model of Acute Renal Failure

et al. 1990

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The objectives of this study were first to develop a reproducible and reversible model of acute renal failure following contrast medium infusion in the rat; second to use that method to compare the nephrotoxicity of low- and high-osmolar contrast agents. Contrast media or saline were perfused in the aorta while a clamp was applied on the aorta just above the renal artery. Three minutes of renal ischemia with or without infusion of isotonic saline induced no change in serum creatinine and a slight and transient decrease in creatinine clearance at 24 h. Urinary N-acetyl glucosamidase (NAG) excretion was not modified in this control group. All 17 kidneys which were examined were normal. 2,100 mosm/kg hypertonic saline induced a significant increase in serum creatinine and a significant decrease in creatinine clearance (from 1.8 ± 0.1 to 0.8 ± 0.1 and 1.0 ± 0.2 ml/min at 24 and 48 h, respectively). Urinary NAG excretion increased from 23 ± 18 to 48 ± 20 and 8 ± 4 umol hrVmmol creatinine at 24 and 48 h, respectively (p < 0.05). Histologic analysis of 5 kidneys revealed acute tubular necrosis (n = 3) and no histologic abnormalities (n = 2). Diatrizoate induced an acute and reversible renal failure. Creatinine clearance decreased from 1.6 ± 0.1 to 0.4 ± 0.1 and 0.8 ± 0.1 ml/min at 24 and 48 h, respectively (p < 0.01). Urinary NAG excretion increased also significantly from 43 ± 9 to 352 ± 79 and 64 ± 23 umol h^_1/mmol creatinine at 24 and 48 h, respectively. Histologic examination of 7 kidneys revealed acute tubular necrosis (n = 4), tubular cytoplasmic vacuolization (n = 2), and no histologic abnormalities (n = 1). Ioxaglate and iopamidol induced no change in serum creatinine and a slight decrease in creatinine clearance comparable to that observed in the control group. Ioxaglate and iopamidol induced a significant increase in urinary NAG excretion at 24 h (ioxaglate: 31 ± 6 to 147 ± 31; iopamidol: 55 ± 20 to 123 ± 31 umol h^_1/mmol creatinine) which was completely reversible at 48 h (ioxaglate: 31 ± 9; iopamidol: 41 ± 8). Histological analysis of 8 kidneys exposed to ioxaglate revealed tubular cytoplasmic vacuolisation (n = 7) and no histologic abnormalities (n = 1). Histological analysis of 10 kidneys exposed to iopamidol revealed tubular cytoplasmic vacuolization (n = 8) and no histologic abnormalities (n = 2). We have described a reproducible and reversible model of contrast-medium-induced acute renal failure in the rat. In this model, ionic and nonionic low-osmolar contrast agents are less nephrotoxic than high-osmolar contrast agents.

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“…However, the use of iodinated contrast media injection (ICMI) for angiography can cause contrast-induced nephropathy (CIN) especially in patients with previously compromised renal function, for example after severe hypotension or after cardiovascular surgery. [21][22][23][24] As for all ICMI exams in intensive care unit, adequate hydratation is used to prevent CIN; however, mannitol, bicarbonates, or diuretic injections are not usually used in France. Diabetic patients are particularly prone to iodinated CIN sometimes requiring the use of renal replacement therapy, temporarily or permanently.…”

mentioning

confidence: 99%

The use of contrast media in deceased kidney donors does not affect initial graft function or graft survival

Vigneau

Fulgencio

Godier

et al. 2006

Kidney International

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Patients receiving cadaveric kidney transplants often experience delayed graft function. As iodinated contrast media injection (ICMI), necessary for cerebral angiography, which is often used to diagnose brain death, can be nephrotoxic, we compared renal function recovery (RFR) and 1-year and long-term graft survival according to the method used to diagnose brain death. Data from 9921 cadaveric kidneys, transplanted between 1 January 1998 and 31 December 2003, were retrieved from the French National Registry for organ donation. We defined RFR as the number of days for the recipient to reach a plasma creatinine less than 250 mumol/l, and/or a 24-h urine output greater than 1000 ml. RFR and 1-year and long-term graft survival were compared between four different donor groups (according to ICMI and diabetes mellitus). A total of 41.5% of deceased donors received ICMI before organ procurement and 1.95% of them were diabetic. History of ICMI or diabetes in the donor did not influence RFR or 1-year graft survival. Long-term graft survival was decreased in the group of patients transplanted with a diabetic graft as compared to patients transplanted with a non-diabetic graft (P=0.001). History of ICMI in the donor did not affect long-term graft survival in the non-diabetic donor group (P=0.2); however, in the diabetic group, ICMI tended to decrease long-term graft survival (P=0.056). ICMI did not affect RFR or graft survival in non-diabetic deceased donors. However, its use in diabetic deceased donors requires further study.

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Nephrotoxicity of Radiocontrast Media in Ischemic Renal Failure in Rabbits

Cited by 17 publications

References 12 publications

Comparative Effects of Low- and High-Osmolar Contrast Media on the Renal Function during Early Degenerative Gentamicin-lnduced Nephropathy in Rats

Comparative Effects of Low- and High-Osmolar Contrast Media on the Renal Function during Early Degenerative Gentamicin-lnduced Nephropathy in Rats

Renal Effects of Radiocontrast Agents in Rats: A New Model of Acute Renal Failure

The use of contrast media in deceased kidney donors does not affect initial graft function or graft survival

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