Radiocontrast Nephrotoxicity in Diabetes: Clinical Considerations and Studies in the Diabetic Rat

Vaamonde, Carlos A.; Papendick, Rebecca; Gouvea, Walter; Bier, Ruth Teresa; Alpert, Helen

doi:10.1007/978-1-4757-2040-2_73

Cited by 1 publication

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“…Sodium iothalamate, 80% (Angio-Conray, Mallinckrodt Specialty Chemicals, St. Louis, MO), was injected through the arterial cannula over 2-3 min, at the dosage of 6 ml/kg body weight (or 2.9 g of organically bound iodine/kg body weight). As shown repeatedly (18)(19)(20)(21), although high doses of radiocontrast administered to normal animals may induce transient reduction of glomerular filtration rate, sustained renal failure is rarely produced. To increase the likelihood of renal injury, the rats were preconditioned by inhibition of the synthesis of prostaglandin and/or nitric oxide.…”

Section: Methodsmentioning

confidence: 99%

Nitric oxide and prostanoids protect the renal outer medulla from radiocontrast toxicity in the rat.

Agmon¹,

Peleg²,

Greenfeld³

et al. 1994

J. Clin. Invest.

323

236

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Human radiocontrast nephrotoxicity is predicted by the presence of multiple risk factors, often associated with compromised renal circulation. To produce a simple model of radiocontrast nephropathy, rats were pretreated with indomethacin and Nw-nitro-L-arginine methyl ester (L-NAME, to inhibit nitric oxide synthesis) before the administration of iothalamate. Acute renal failure consistently developed, with a decline in creatinine clearance from 1.05±0.10 to 0.27±0.05 ml/min (P < 0.001) associated with selective necrosis of 49±9% of medullary thick ascending limbs.Hemodynamic studies using laser-Doppler probes revealed that when injected alone, iothalamate increased outer medullary blood flow to 196±25% of baseline (P < 0.001). Pretreatment by L-NAME or indomethacin both reduced basal medullary blood flow and transformed the medullary vasodilator response to radiocontrast into vasoconstriction, with a prolonged reduction of medullary blood flow to less then half of baseline. Combined administration of indomethacin, L-NAME, and iothalamate lowered medullary blood flow to 12±4% of baseline.We conclude that prostanoids and nitric oxide have an important protective role in the renal response to radiocontrast material. Reduced synthesis of these vasoactive substances in renal/vascular diseases may predispose patients to radiocontrast nephropathy. (J. Clin. Invest. 1994.

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Section: Methodsmentioning

confidence: 99%