Radiocontrast‐induced natriuresis associated with increased urinary urodilatin excretion

Autor: Forssmann Wg, Christlieb Haller, Scheele T, Armin Koch, Wolfgang Kübler, Meyer M
Rok vydání: 1998
Předmět:
Zdroj: Journal of Internal Medicine. 243:155-162
ISSN: 1365-2796
0954-6820
DOI: 10.1046/j.1365-2796.1998.00260.x
Popis: Haller C, Meyer M, Scheele T, Koch A, Forssmann W-G and Kubler W (University of Heidelberg; and Lower Saxony Institute for Peptide Research, Hanover; Germany). Radiocontrast-induced natriuresis associated with increased urinary urodilatin excretion (original article). J Intern Med 1998; 243: 155–62. Objective Intravascular radiocontrast agents induce a pronounced diuresis. The aim of the present study was to investigate the (patho-)physiological mechanisms of the radiocontrast-induced diuresis. Design The fractional excretion of sodium, the urinary excretion of the renal natriuretic peptide urodilatin and the plasma concentration of atrial natriuretic peptide were measured in 42 unselected patients immediately before and after intravascular radiocontrast administration during coronary angiography. Setting Cardiac catheterization laboratory of a university hospital. Results After angiography both the plasma concentration of atrial natriuretic peptide (median post-pre difference: 3.9 pmol L−1, quartiles −1.2; 7.0) and the urinary excretion of urodilatin (median post-pre difference: 67.0 nmol urodilatin/mol creatinine, quartiles 39.7; 152.1) were increased. The urinary urodilatin excretion was correlated with an increase in the fractional excretion of sodium (median post-pre difference: 1.7%, quartiles 0.6; 3.1). There was no correlation between the serum concentration of atrial natriuretic peptide and urinary sodium excretion. For the radiocontrast-induced increase in both urodilatin and sodium excretion there was no indication for differences between patients without (31) and with (11) intravenous saline infusion. Conclusion The radiocontrast-induced diuresis is a natriuresis which is associated with an increased urinary excretion of urodilatin. The association between natriuresis and urinary urodilatin excretion irrespective of baseline volume status corroborates the hypothesis that urodilatin contributes to the sodium excretion after radiocontrast administration in a paracrine manner. This finding has pathophysiological and potentially therapeutic implications in radiocontrast-induced nephropathy.
Databáze: OpenAIRE
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