Analysis of Radiocontrast-Induced Nephropathy by Dual-Labeled Radionuclide Clearance
| Autor: | STEWART G. ALBERT, MARC J. SHAPIRO, WENDY W. BROWN, HENRY G00DGOLD, DARRYL ZUCKERMAN, RODNEY DURHAM, MORTON KERN, JAMES FLETCHER, MICHAEL WOLVERSON, E SHARON PLUMMER, ARTHUR E BAUE |
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| Rok vydání: | 1994 |
| Předmět: |
Male
medicine.medical_specialty Urology Contrast Media Renal function Kidney Placebo chemistry.chemical_compound Adenosine Triphosphate Double-Blind Method Internal medicine medicine Humans Radiology Nuclear Medicine and imaging Radionuclide Imaging Technetium Tc 99m Pentetate Aged Creatinine Dose-Response Relationship Drug business.industry Pentetic acid Indium Radioisotopes Acute kidney injury General Medicine Acute Kidney Injury Middle Aged Pentetic Acid medicine.disease Adenosine Endocrinology medicine.anatomical_structure chemistry Female business Glomerular Filtration Rate medicine.drug |
| Zdroj: | Investigative Radiology. 29:618-623 |
| ISSN: | 0020-9996 |
| DOI: | 10.1097/00004424-199406000-00004 |
| Popis: | RATIONALE AND OBJECTIVES: This study was devised to develop a method of measuring the acute effects of radiocontrast media on renal function and assessing the relationship of the dose of radiocontrast media infused with the incidence of radiocontrast-induced renal failure. In addition, the drug adenosine phosphate-magnesium chloride (ATP-MgCl2) was evaluated as a renoprotective agent. METHODS: Eighteen patients with pre-existing renal impairment, (serum creatinine greater than 133 mumol/L) were randomized to receive a continuous infusion of ATP-MgCl2 or placebo before and during a radiocontrast procedure. Subjects were monitored with daily serum creatinine and with radionuclide renal clearance studies at baseline, during, and 24 hours after the radiocontrast procedure. RESULTS: There was an initial deterioration in renal clearance in the entire study group (from 44.2 +/- 4.6 to 32.6 +/- 3.9 mL/min, P = .001) which was independent of the dose of radiocontrast infused. There was a persistent deterioration in renal clearance only in those who received greater than 135 mL of contrast media (from 48.6 +/- 7.8 to 37.1 +/- 3.9 mL/min, P = .05). There also was an increase in serum creatinine that persisted only in those subjects who received greater than 135 mL of contrast media (230 +/- 27 to 283 +/- 44 mumol/L, P = .01). CONCLUSION: Persistent deterioration in renal function after radiocontrast administration appears to be dose-dependent and is not prevented by the use of ATP-MgCl2. Radionuclide techniques are useful in monitoring acute changes in renal function during radiocontrast procedures and may be of value in assessing renal impairment in future intervention studies. |
| Databáze: | OpenAIRE |
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