Osmotic Nephrosis Induced by Water-Soluble Triiodinated Contrast Media in Man

Moreau, Jean-François; Droz, Dominique; Sabto, J.; Jungers, Paul; Kleinknecht, D; Hinglais, N; Michel, Jean‐Baptiste

doi:10.1148/115.2.329

Cited by 110 publications

(24 citation statements)

References 12 publications

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“…These enyzmatic findings are parallel to the histologi cal studies, which have shown structural changes in the proximal tubular cells [8,15,16], However, the interpre tation of the enzymatic and morphologic alterations has remained unclear, and the correlation of such results to renal function has not been definitely demonstrated [17], Furthermore, categorical confirmation of CM-associated nephrotoxicity is still lacking.…”

Section: Introductionmentioning

confidence: 57%

Structural Changes in the Renal Proximal Tubular Cells Induced by lodinated Contrast Media

Tervahartiala

Kivisaari

et al. 1997

Nephron

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The renal morphologic changes induced by intravenously injected contrast media (CMs) were studied in 40 Wistar rats which had been deprived of water 24 h before the CM injection. In the first part of the investigation, the kidneys were fixed by perfusion for light and electron microscopy 2 h after injection of 3 g iodine/kg of iopamidol, iobitridol or iohexol. Control animals received physiologic saline. In the second part of the study, the fixation was performed 48 h after the injection of the corresponding dose of iobitridol or iohexol. The structural changes were semiquantitatively evaluated by two independent observers unaware of the agent injected. The lysosomes of the proximal convoluted tubular cells showed moderate changes 2 h after the iopamidol injection. Iobitridol and iohexol induced prominent lysosomal alterations with signs of cytoplasmic injury. After 48 h, the changes induced by iobitridol had almost disappeared, whereas the iohexol group still showed a statistically significant vacuolization. Although the general physicochemical properties of iobitridol and iohexol appear similar in vitro, the different lysosomal alteration might reflect differences in their characteristics in vivo.

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Section: Introductionmentioning

confidence: 57%

Structural Changes in the Renal Proximal Tubular Cells Induced by lodinated Contrast Media

Tervahartiala

Kivisaari

et al. 1997

Nephron

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“…The most significant characteristic of this phenomenon includes a focal or diffuse vacuolization of the proximal tubule or even tubular necrosis. In an early study conducted by Moreau et al [49 ]on 211 patients who underwent renal biopsy within 10 days of the angiographic procedure, there were 47 cases of osmotic nephrosis and contemporary tubular atrophy or necrosis in 29 patients. Osmotic nephrosis often develops in patients with severe baseline impairment of renal function.…”

Section: Pathophysiology Of Contrast-induced Nephropathymentioning

confidence: 99%

Contrast-Induced Nephropathy in Percutaneous Coronary Interventions: Pathogenesis, Risk Factors, Outcome, Prevention and Treatment

Aurelio¹,

Durante²

2014

Cardiology

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Contrast-induced nephropathy (CIN) is a well-known adverse event of therapeutic and diagnostic procedures requiring the adminstration of contrast medium (CM). The lack of a universal CIN definition and glomerular filtration rate markers that vary have resulted in a variety of reported incidences. The development of CIN is associated with an increase in the length of hospital stay and the risk of death. Preexisting renal dysfunction, age, diabetes, congestive heart failure and the volume of CM administered are all associated with a risk for developing CIN. The literature suggests the use of low-osmolarity CM and supports volume supplementation before administration. Moreover, other strategies to avoid CIN, including treatment with N-acetylcisteine and sodium bicarbonate have variable levels of evidence. This review examines the main components of the pathogenesis and risk factors of CIN and possible preventive measures and therapies.

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“…Moreau et al (42) described vacuolization in the proximal convoluted tubules as one of the first structural changes in nephrotoxicity. A subsequent experiment by Tervahartiala et al (43) that compared morphologic changes in rat kidneys after injection of high-, low-, and iso-osmolar iodinated contrast agents with Magnevist showed clear vacuolization within two hours of any iodinated contrast treatment, but no vacuolization up to 48 hours after Magnevist.…”

Section: Nephrotoxicitymentioning

confidence: 99%

MR contrast agents: Physical and pharmacologic basics

Lin

Brown

2007

Magnetic Resonance Imaging

223

175

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Since approval of the first magnetic resonance (MR) contrast agent was granted in 1988, there has been remarkable growth in the utilization of intravenous gadolinium (Gd)-based agents. Currently it is estimated that nearly half of all MR studies performed are contrast-enhanced. Despite containing a toxic heavy metal, these agents have proven to be not only an effective diagnostic adjunct to non-enhanced MRI, but also remarkably well tolerated and safe. As a result, conventional wisdom has been that MR contrast media are "biologically inert," a notion that is clearly false. Ultimately, it is the radiologist's responsibility to understand the potential adverse effects of Gd-based agents and the special situations in which they are likely to occur; however, the basic pharmacology of contrast agents is generally not included in medical school curricula or formally taught in residency. The purpose of this review is to discuss the mechanism of action of MR contrast agents and relevant aspects of their clinical pharmacology, including effects on the cardiovascular and renal systems, potential laboratory errors, and special situations involving women and children. We also briefly discuss the issue of nephrogenic systemic fibrosis (NSF).

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Osmotic Nephrosis Induced by Water-Soluble Triiodinated Contrast Media in Man

Cited by 110 publications

References 12 publications

Structural Changes in the Renal Proximal Tubular Cells Induced by lodinated Contrast Media

Structural Changes in the Renal Proximal Tubular Cells Induced by lodinated Contrast Media

Contrast-Induced Nephropathy in Percutaneous Coronary Interventions: Pathogenesis, Risk Factors, Outcome, Prevention and Treatment

MR contrast agents: Physical and pharmacologic basics

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