“…[25][26][27] Moreover, low blood flow in the medulla, which has a high demand for oxygen, might result from increased perivascular hydrostatic pressure, high viscosity, or changes in vasoactive substances such as endothelin, NO, and adenosine. 28,29 Furthermore, contrast agents have direct toxic effects on kidney tubular cells, inducing vacuolization, change in mitochondrial function, and even apoptosis. 28,30 In this study, CIN significantly increased denudation of tubular cells, tubule dilatation and intratubular obstruction by granular casts, but subsided following administration of 2 and 10 lM SPC.…”