urografin-76 and Kidney-Diseases

The purpose of this research was to study the effects of the radiocontrast medium (CM) Hypaque-76 (diatrizoate meglumine sodium), equiosmolar mannitol, and endothelin on blood pressure and renal damage in a aging male spontaneously hypertensive rat, a small animal model for CM-induced renal damage. The importance of the pressor effect and the high osmolality of CM in producing renal damage was investigated by first reducing the blood pressure with pentobarbital anesthesia, which suppresses sympathetic nervous system activity, then testing the effects of CM, saline, mannitol, and the potent vasoconstrictor endothelin alone and in combination with CM.. Systolic blood pressure was measured in 14-month-old male rats (1) when awake, (2) after pentobarbital anesthesia, (3) after the administration of saline, CM, mannitol, endothelin, or CM plus endothelin, (4) after awakening the same day, and (5) the following day while awake. Renal damage was quantified by evaluating histopathologically the left kidney removed the day after administration of test substances.. The pentobarbital-lowered blood pressure remained depressed after saline and mannitol but rose dramatically after CM, endothelin, and CM plus endothelin. Renal damage, compared with the saline controls, occurred with CM, mannitol, endothelin, and endothelin plus CM. The order of increasing severity was mannitol = CM < endothelin < endothelin plus CM.. The effect of CM on systolic blood pressure is not related to its osmolality. High osmolality, however, appears to be a factor in CM-induced renal damage. Ischemia and direct nephrotoxicity are factors contributing to the renal-damaging effects of CM, mannitol, and endothelin.

Topics: Aging; Animals; Blood Pressure; Contrast Media; Diatrizoate; Diatrizoate Meglumine; Diuretics, Osmotic; Drug Combinations; Endothelins; Hypertension; Kidney Diseases; Male; Mannitol; Rats; Rats, Inbred SHR

In the present study we investigated the role of endothelin and AT II in radiocontrast nephropathy induced in rats with reduced renal mass (70-75%). Thirty-five male Wistar albino rats weighing between 280 and 400 g were anaesthetized with ketamine (130 mg/kg b.w.) and right total, left 50% nephrectomy were performed. After this operation, the rats were kept under observation for six to eight weeks and then they were randomly separated into three groups. Group I rats were infused with 8.9 ml/kg (or 2.9 g of iodine/kg body weight) Na diatrizoate (Urovision, 1,500 mosm/kg). Group II rats were infused with 0.9% NaCl in an equal volume with the radiocontrast material. Group III rats were given 4.5% NaCl that had the same volume and osmolality as the radiocontrast material. Two hours after the drug infusions, blood and accumulated urine samples were collected from all the rats and tested for endothelin, AT II, BUN, creatinine, uric acid, electrolytes, calcium and phosphorus. We found that the plasma endothelin levels in Group I (77.64 +/- 29.62 pg/ml) were significantly higher than in Group II (20.52 +/- 5.83 pg/ml) and Group III (15.04 +/- 5.15 pg/ml) (t = 8.34 and t = 9.14, respectively, p < 0.001). Therefore elevation in circulating endothelin might have been an additional factor leading to the radiocontrast-induced nephrotoxicity.

Topics: Angiotensin II; Animals; Blood Urea Nitrogen; Contrast Media; Diatrizoate; Diatrizoate Meglumine; Disease Models, Animal; Drug Combinations; Endothelins; Infusions, Intravenous; Iodine; Kidney; Kidney Diseases; Male; Nephrectomy; Radioimmunoassay; Radioisotopes; Random Allocation; Rats; Rats, Wistar; Reference Values

24 h urinary excretion of beta-microglobulin (beta 2M) and Tamm-Horsfall protein (THP) before and after administration 40 ml of 75% Uropoline were assessed, as a specific markers of proximal and distal tubular dysfunction respectively. 22 patients without renal diseases and hypertension (C), 22 hypertensive patients (HP), 14 patients with renal stone disease (RSD) and 16 patients with pyelonephritis (PN) were examined. Administration of Uropoline did not change beta 2M and THP urinary excretion in C, but increased beta 2M excretion in HP and decreased THP urinary excretion in patients with RSD. It is concluded, that Uropoline shows a noxious effect on the proximal tubule in HP and on the distal tubule in patients with RSD.

Topics: Adult; Contrast Media; Diatrizoate; Diatrizoate Meglumine; Drug Combinations; Humans; Kidney Diseases; Kidney Function Tests; Kidney Tubules; Middle Aged

Contrast-induced renal dysfunction has been reported to occur in 15% to 42% of patients with underlying azotemia, but there is disagreement as to whether its incidence is reduced by limiting the amount of contrast material. To adjust the amount of contrast material to the severity of azotemia, we have utilized the following formula to calculate a contrast material "limit" in patients with renal disease: Contrast material limit = (formula; see text). Over a 10-year period, 115 patients (53 men, 62 women, aged 61 +/- 11 [mean +/- SD] years) with renal dysfunction (baseline serum creatinine level greater than or equal to 1.8 mg/dL) underwent cardiac catheterization and angiography, after which the level of serum creatinine was measured daily for five days. The amount of contrast material that was given adhered to the limit in 86 patients (Group I) and exceeded it in 29 (Group II).. Contrast-induced renal dysfunction (an increase in serum creatinine greater than or equal to 1.0 mg/dL) occurred in two (2%) patients in Group I and in six (21%) patients in Group II (p less than 0.001). Of the 48 patients with concomitant diabetes mellitus, the contrast limit was surpassed in 16, six (38%) of whom had contrast nephropathy. Only two of the 32 (6%) diabetic patients in whom the contrast limit was not exceeded had contrast nephropathy (p less than 0.001).. Thus, contrast-induced renal dysfunction occurs infrequently if the amount of contrast material is limited in accordance with the degree of azotemia. Diabetic patients have a high incidence of contrast nephropathy, particularly when they receive an excessive amount of contrast. In patients with diabetes and renal impairment, it may be preferable to perform angiography as a staged procedure or to utilize alternative (non-contrast) techniques to obtain the desired information rather than to exceed the prescribed contrast limit.

Topics: Acute Kidney Injury; Angiography; Cardiac Catheterization; Contrast Media; Creatinine; Diabetic Nephropathies; Diatrizoate; Diatrizoate Meglumine; Drug Combinations; Female; Fluid Therapy; Humans; Kidney Diseases; Male; Middle Aged; Time Factors