Transient Glomerular Proteinuria, Enzymuria, and Nephrotoxic Reaction Induced by Radiocontrast Media

Nicot, G; Merle, Louis; Charmes, Jean-Pierre; Valette, Jean-Paul; Nouaille, Y.; Lachâtre, Gérard; Leroux-Robert, C.

doi:10.1001/jama.1984.03350170034015

Cited by 42 publications

(4 citation statements)

References 14 publications

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“…In addition, even without causing renal dysfunction, the contrast agent has many renal impacts such as proteinuria, enzymuria, and increased urinary pH (14,17). In their study investigating the effect of exposure to nonionic radiocontrast agents on microalbuminuria in patients undergoing angiography, Chu et al (18) reported that ordinary dose low osmolar contrast agents had no significant effect on the presence and level of microalbuminuria.…”

Section: Discussionmentioning

confidence: 99%

“…Albuminuria, a known marker for the progression of chronic renal disease, is a direct consequence of glomerular damage and increases in glomerular dysfunction (13). It has been previously shown that contrast agent has toxic renal effects such as enzymuria and proteinuria without causing nephropathy (7,14). In this study, we aimed to quantitatively (using the urinary Alb/Cr ratio) demonstrate the potential effect of a contrast agents, without causing significant renal dysfunction, on glomerular albumin loss, in patients who underwent CT for various reasons.…”

Section: Introductionmentioning

confidence: 99%

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Effects of contrast medium exposure on urine albumin/creatinine ratio

KAYHAN

KİVRAKOGLU

YARLIOGLU

et al. 2022

Journal of Health Sciences and Medicine

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Aim: Albuminuria is a direct consequence of renal glomerular injury and increases with glomerular dysfunction. Spot urine albumin/creatinine (Alb/Cr) ratio is a reasonable surrogate for 24-hour urine albumin excretion rate and certainly not without limitations. It is known that renal function can be affected following contrast agent administration. The aim of our study is to assess the changes in Alb/Cr ratio in spot urine before and after contrast agents in patients undergoing computed tomography (CT) scanning. Material and Method:The present study included 103 hospitalized patients aged between 18 and 75 years, who underwent contrast-enhanced CT scanning for any reason and did not develop contrast-induced nephropathy (CIN). We compared the values of Alb/Cr ratio at the 6th, 12th, 24th, 48th, and 72nd hours after the procedure (post-procedure time) with the values at pre-procedure time. Results:The median age of the patients were 61 years. It has been observed that there is no significant increased in microalbuminuria after the use of contrast media. When the patients were evaluated for the albuminuria level before the procedure, it has been seen that 73 patients (70.9%) had an Alb/Cr ratio of <30 mg/g (group-1) and 30 patients (29.1%) had an Alb/Cr ratio of ≥30 mg/g (group-2). In group 1, it has been observed that the Alb/Cr ratios at the post-procedure 6th, 12th, 24th, and 48th hours were statistically significantly higher than the value at pre-procedure time. In group 2, it has been observed that Alb/Cr ratio values at all post-procedure time except the 24th hour were statistically significantly lower than the values at the pre-procedure time. Conclusion: It should be considered that there might be changes in Alb/Cr ratio even without developing significant complications such as CIN in patients exposed to contrast medium.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Effects of contrast medium exposure on urine albumin/creatinine ratio

KAYHAN

KİVRAKOGLU

YARLIOGLU

et al. 2022

Journal of Health Sciences and Medicine

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“…Iodinated radiocontrast material is also directly toxic to renal epithelial cells as manifested by the finding of epithelial cell injury and enzymuria after the administration of radiocontrast [30,[51][52][53]. Studies in animal models and humans have also shown that the administration of intravascular radiocontrast results in increased intrarenal production of cytotoxic reactive oxygen species [54,55].…”

Section: Pathophysiologymentioning

confidence: 99%

Radiocontrast-Induced Acute Renal Failure

Weisbord

Palevsky

2005

J Intensive Care Med

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The intravascular administration of iodinated radiocontrast media can lead to acute renal dysfunction. Even small changes in renal function have been associated with increased morbidity and mortality, making the prevention of radiocontrast nephropathy of paramount importance. This review summarizes the principal risk factors for radiocontrast nephropathy and evidence-based preventive strategies that should be used to limit its occurrence. Risk factors for radiocontrast nephropathy include preexistent kidney disease, diabetes mellitus, dose of radiocontrast used, advanced congestive heart failure, and intravascular volume depletion. Proven preventive measures include volume expansion with intravenous saline or sodium bicarbonate and the use of low-osmolar or iso-osmolar radiocontrast media. Studies evaluating N-acetylcysteine have been conflicting, with meta-analyses suggesting a small beneficial effect. Studies of other pharmacologic agents have not demonstrated clinical benefit.

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“…The signs are mostly a mild detoriation of the renal function with transient proteinuria and signs of tubular damage. 1 The numbers of contrast media-enhanced examinations are increasing. The annual sale of iodine for contrast media now represents 60 million doses a year worldwide.…”

Section: Introductionmentioning

confidence: 99%

Radiocontrast induced nephropathy

Lindholt

2003

European Journal of Vascular and Endovascular Surgery

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In spite of improvements in chemical structure, contrast media assisted X-ray examination is still the third leading cause of hospital-acquired acute renal failure. An increase >50% or >88 micro mol/L in S-creatinine is a clinically important acute renal failure. The peak in S-creatinine occurs within 2-5 days after exposure. The frequency of oliguria, transient or permanent haemodialysis is unknown. The cause is a hypoxic tubular injury due to vasoconstriction with release of free oxygen radicals. Major risk factors are prior renal insufficiency and diabetes mellitus. Minor risk factors are congestive heart disease, dehydration, hypotension, hypoxia, amount of contrast, ionic and high osmolar contrast, repeated examinations at short intervals, abdominal examination, and perhaps age, smoking, hypercholesterolaemia, and use of Non-Steroidal Anti inflammatory Drug. Prevention seems possible by omission or reduction of contrast, ameliorating predisposing factors, saline hydration 24h before and after exposure, and 600 mg acetylcysteine orally twice daily 24h before and after exposure. A three-day treatment with 20mg nitrendipine daily, starting 1 day before examination may also be preventive. The present research is unfortunately characterised by small numbers, lack of clinical important renal failure, and lack of long term results. The latter may be important after new data indicate that radiation may trigger a chronic oxidative process through a similar pathway.

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Transient Glomerular Proteinuria, Enzymuria, and Nephrotoxic Reaction Induced by Radiocontrast Media

Cited by 42 publications

References 14 publications

Effects of contrast medium exposure on urine albumin/creatinine ratio

Effects of contrast medium exposure on urine albumin/creatinine ratio

Radiocontrast-Induced Acute Renal Failure

Radiocontrast induced nephropathy

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