Histomorphological changes after renal X-ray arteriography using iodine and gadolinium contrast media in an ischemic porcine model
| Autor: | Peter Leander, Torsten Almén, Ulf Nyman, Barbara Elmståhl, Jonas Björk, Chun-Ming Chai, Derek Grant, Richard W. Doughty |
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| Rok vydání: | 2007 |
| Předmět: |
Male
medicine.medical_specialty Swine Gadolinium chemistry.chemical_element Contrast Media Iodine Kidney Gadobutrol Random Allocation Ischemia medicine Animals Radiology Nuclear Medicine and imaging Radiological and Ultrasound Technology medicine.diagnostic_test business.industry Gadodiamide Iopromide Angiography General Medicine Iodixanol Disease Models Animal chemistry Kidney Cortex Necrosis Radiology Iohexol business medicine.drug Glomerular Filtration Rate |
| Zdroj: | Acta radiologica (Stockholm, Sweden : 1987). 48(10) |
| ISSN: | 1600-0455 |
| Popis: | Background: Gadolinium contrast media (Gd-CM) are regarded as non-nephrotoxic or considerably less nephrotoxic than iodine contrast media (I-CM), and have therefore come to be used as a substitute for I-CM in patients with renal insufficiency in a variety of radiographic examinations. Purpose: To investigate renal histomorphological changes caused by Gd-CM in comparison with I-CM after renal X-ray arteriography in an ischemic porcine model, and to evaluate these changes in relation to the nephrotoxicity of the CM used. Material and Methods: Test solutions: gadopentetate, gadodiamide, iohexol, gadobutrol, iopromide, iodixanol, mannitol, and saline. The experiments were performed on 152 animals. Each pig was randomized to receive one test solution injected into the balloon-occluded (10 min) right renal artery. The kidneys were evaluated histomorphologically. The severity of histomorphological changes was graded subjectively: 1 = minimal, 2 = mild, 3 = moderate, and 4 = marked. Results: The main histological changes were 1) proximal tubular and glomerular necrosis, 2) hemorrhage/congestion of the cortex, medulla, and glomeruli, 3) proximal tubular vacuolation, and 4) protein-filled tubules in the cortex and medulla. Necrosis and hemorrhage/congestion were more frequent after injections with gadopentetate, mannitol solution iso-osmotic to gadopentetate, and gadobutrol compared to all other groups ( P Conclusion: In ischemic porcine kidneys, the histomorphological changes caused by Gd-CM are similar to those caused by I-CM. Vacuolation appears to be independent of the osmolality and viscosity of the CM, and does not seem to be an indicator of renal impairment. “High-osmolal” Gd-CM are more nephrotoxic than “low- and iso-osmolal” I-CM when compared in equal volumes of concentrations, resulting in equal X-ray attenuation. |
| Databáze: | OpenAIRE |
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