Intravenous urography with iopamidol in children with reflux and obstructive nephropathy: effects on glomerular and tubular functions and the renin-angiotensin-aldosterone system.
Twenty-seven children [2 with chronic renal failure (CRF)] with reflux or obstructive nephropathy underwent intravenous urography with iopamidol 370, a nonionic contrast medium 1 (CM), osmolality 796 mosmol/kg, for renal growth evaluation. Mean iopamidol dosing was 1.69 ml/kg (range 1.22-2.42); the 2 children with CRF received 2 and 2.42 ml/kg respectively. One hour after infusion a significant decrease in haematocrit, haemoglobin, plasma sodium (Na+), chloride (Cl-), renin activity and aldosterone was observed, consistent with a possible plasma volume expansion due to the slightly hypertonic CM. At the same time there was a significant increase in fractional excretion of Na+, Cl- and potassium, probably due to the haemodynamic effects and tubular response to a substance acting as on osmotic diuretic. The -24 to +48 h monitoring of albuminuria, beta-2-microglobulin excretion, and in 4 children excretion of N-acetyl-beta-glucosaminidase and alanine-aminopeptidase did not show any relevant nephrotoxicity. No untoward effect of clinical relevance was observed.
Division of Paediatrics, Fornaroli Hospital, Magenta, Italy.
M
M
Bosio
F
F
Bissoli
G
G
Vignati
M G
MG
Fiori
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D004231:Diuresis / Q000187:drug effects; D005919:Glomerular Filtration Rate; D006801:Humans; D007223:Infant; D007275:Injections, Intravenous; D007479:Iopamidol / Q000009:adverse effects; D007674:Kidney Diseases / Q000000981:diagnostic imaging*; D007676:Kidney Failure, Chronic / Q000000981:diagnostic imaging*; D007684:Kidney Tubules / Q000187:drug effects; D009994:Osmolar Concentration; D012084:Renin-Angiotensin System / Q000187:drug effects*; D014567:Urography; D001613:beta 2-Microglobulin / Q000652:urine
D001613:beta 2-Microglobulin; D007479:Iopamidol