Urography into the 21st century: new contrast media, renal handling, imaging characteristics, and nephrotoxicity.

Katzberg, Richard W.

doi:10.1148/radiology.204.2.9240511

Cited by 179 publications

(163 citation statements)

References 111 publications

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“…Urinary concentrations of ICM can be up to 50-100 times that in plasma. 23 Furthermore, Spataro et al 24 reported urinary concentration up to approximately 140 mg I/mL at 60 min after administration of 450 mg I/kg ioxaglate in rabbits. The degree of cell death, as determined by the trypan blue exclusion assay reported for iodixanol, iohexol, and iopromide, was generally lower than the control after 1-6 h exposure.…”

Section: Discussionmentioning

confidence: 99%

The Effects of the Iodinated X-Ray Contrast Media Iodixanol, Iohexol, Iopromide, and Ioversol on the Rat Kidney Epithelial Cell Line NRK 52-E

et al. 2011

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Nephrotoxicity, associated with the administration of iodinated X-ray contrast media (ICM), continues to be a major side effect in a significant number of vulnerable patients undergoing diagnostic X-ray imaging procedures. The molecular mechanisms underlying these adverse effects on the kidneys are unclear despite several decades of investigation. Side effects are more common after exposure to high-osmolar compared with low-osmolar ICM, suggesting that osmolality may be an important physical-chemical property related to nephrotoxicity. This investigation in cultured NRK 52-E cells, a cell line of renal origin, compares the in vitro toxicity of the iso-osmolal ICM iodixanol with the lowosmolal ICM iohexol, iopromide, and ioversol. The cellular toxicity was evaluated with the trypan blue exclusion assay, the MTT assay, and incidences of cell death. A qualitative assessment of vacuolation of the cultured NRK 52-E cells was taken as a measure of intracellular uptake of ICM. A difference in cell death incidence was observed between the iso-osmolal iodixanol and the low-osmolal iohexol, iopromide, and ioversol contrast media, with the isoosmolal iodixanol having the least effect in each of the in vitro systems tested. The osmolality of the contrast media appeared to be the major cause for the observed in vitro toxicity.

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Section: Discussionmentioning

confidence: 99%

The Effects of the Iodinated X-Ray Contrast Media Iodixanol, Iohexol, Iopromide, and Ioversol on the Rat Kidney Epithelial Cell Line NRK 52-E

et al. 2011

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“…All hypertonic solutions significantly increased elimination half-life, increasing with the osmolality of the agents. Apart from the direct exposure of red blood cells, endothelial cells, and tubular cells to the hypertonic solutions injected into the renal artery, the CM also represent an osmotic load to the kidneys with secondary diuresis and natriuresis (1,55,56). Osmotic load may activate the tubuloglomerular feedback mechanism mediating vasoconstrictive agents, increase medullary oxygen demand for active reabsorption of the increased tubular sodium load resulting in hypoxic injuries, or increase intratubular pressure with elevation of interstitial pressure and secondary vascular compression beneath the rigid renal capsula.…”

Section: Discussionmentioning

confidence: 99%

Gadolinium contrast media are more nephrotoxic than a low osmolar iodine medium employing doses with equal x-ray attenuation in renal arteriography: An experimental study in pigs1

et al. 2004

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“…Although clinical studies have not uniformly shown that dehydration is a definite risk factor, iodinated contrast agents increase urine volume and osmolar clearance, and their effect on the kidney is prolonged by the decrease in both renal blood flow and GFR, as seen in dehydrated states. 54 Therefore, by increasing the renal perfusion and subsequently diminishing the tubular fluid viscosity, adequate hydration may counteract some of the putative hemodynamic effects that may lead to CI-AKI. The positive effect of hydration has consistently been reported in several studies.…”

Section: Signal Transduction Pathwaysmentioning

confidence: 99%

Remote Ischemic Preconditioning and Renoprotection

Gassanov¹,

Nia

Caglayan³

et al. 2014

Journal of the American Society of Nephrology

122

106

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There is currently no effective prophylactic regimen available to prevent contrastinduced AKI (CI-AKI), a frequent and life-threatening complication after cardiac catheterization. Therefore, novel treatment strategies are required to decrease CI-AKI incidence and to improve clinical outcomes in these patients. Remote ischemic preconditioning (rIPC), defined as transient brief episodes of ischemia at a remote site before a subsequent prolonged ischemia/reperfusion injury of the target organ, is an adaptational response that protects against ischemic and reperfusion insult. Indeed, several studies demonstrated the tissue-protective effects of rIPC in various target organs, including the kidneys. In this regard, rIPC may offer a novel noninvasive and virtually cost-free treatment strategy for decreasing CI-AKI incidence. This review evaluates the current experimental and clinical evidence for rIPC as a potential renoprotective strategy, and discusses the underlying mechanisms and key areas for future research.

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Urography into the 21st century: new contrast media, renal handling, imaging characteristics, and nephrotoxicity.

Cited by 179 publications

References 111 publications

The Effects of the Iodinated X-Ray Contrast Media Iodixanol, Iohexol, Iopromide, and Ioversol on the Rat Kidney Epithelial Cell Line NRK 52-E

The Effects of the Iodinated X-Ray Contrast Media Iodixanol, Iohexol, Iopromide, and Ioversol on the Rat Kidney Epithelial Cell Line NRK 52-E

Gadolinium contrast media are more nephrotoxic than a low osmolar iodine medium employing doses with equal x-ray attenuation in renal arteriography: An experimental study in pigs1

Remote Ischemic Preconditioning and Renoprotection

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