Glomerular and Tubular Effects of Contrast Media Diatrizoate and Iopromide
作者:
DonadioCarlo,
LucchesiAnnalisa,
TramontiGianfranco,
CalderazziAndrea,
GibiliscoGaetano,
PaolicchiAlessandro,
GiordaniRoberto,
BianchiClaudio,
期刊:
Renal Failure
(Taylor Available online 1996)
卷期:
Volume 18,
issue 4
页码: 657-666
ISSN:0886-022X
年代: 1996
DOI:10.3109/08860229609047691
出版商: Taylor&Francis
关键词: Contrast media;Diatrizoate;Iopromide;Nephrotoxicity;Tubular function;Urinary enzymes;Renal hemodynamics;Glomerular filtration rate;Effective renal plasma flow
数据来源: Taylor
摘要:
The aim of this study is to evaluate the nephrotoxicity of two contrast media (CM), with different physicochemical characteristics: diatrizoate (ionic high-osmolar), iopromide (nonionic low-osmolar). Intravenous urography was performed in 34 patients: 17 were examined with diatrizoate and 17 with iopromide, randomly assigned. Different parameters of glomerular and tubular function were measured before and at 6, 24, and 48 h after urography. Both contrast media induced a reversible increase of urine enzymes, which was significantly higher after diatrizoate. In particular, diatrizoate determined a relevant increase of brush border enzymes -γ-glutamyltransferase (GGT) and alkaline phosphatase (ALP) and of cytosolic enzyme lactate dehydrogenase (LDH), while, after iopromide increases of urinary enzymes were less evident and were significant only for GGT and ALP. In addition, diatrizoate affected other tubular functions (clearances of phosphorus and uric acid) and slightly decreased glomerular function in a few patients. In no case did these glomerular and tubular effects have a clinical relevance. In conclusion, the nonionic low-osmolar contrast medium iopromide appeared less nephrotoxic than diatrizoate. The cost-benefit ratio needs further examination.
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