title: Renal handling and physiologic effects of the paramagnetic contrast medium Gd-DOTA.
abstract: Gadolinium DOTA (Gd-DOTA) is a magnetic resonance (MR) contrast agent similar to Gd-DTPA but with greater stability in vitro. The effects of a high intravenous dose (0.5 mmol/kg) of Gd-DOTA (1360 mOsm/kg) on renal excretory function and its general systemic effects are examined in this animal study. This dose was selected to accentuate and better define the qualitative nature of these effects. A decrease in arterial pressure of 8% (131.9 +/- 6.8 at 120 minutes versus a control of 142.8 +/- 3.7 mm Hg, mean +/- standard error of mean, no significant change in electrocardiogram (ECG) lead II, a 16% increase in renal blood flow (106.0 +/- 5.4 at 7.5 minutes versus 91.2 +/- 3.2 ml/min), and a decrease in arterial hematocrit of 9% (38.9 +/- 1.5 at 120 minutes versus 41.9% +/- 1.7%) were noted. In general, qualitatively similar effects have been noted as a nonspecific effect of other hyperosmolar solutions. The filtration fraction decreased (0.23 +/- 0.01 at 7.5 minutes versus 0.28 +/- 0.02) followed by a rapid return to baseline values. No significant change was noted in glomerular filtration rate throughout the experimental protocol. Urine flow increased nearly 1.5-fold and osmolal clearance (Cosm) increased approximately 1.5 times. A natriuresis occurred as the fractional excretion of sodium (FENa+) increased from a control value of 3.5 +/- 0.3 to 5.2 +/- 0.5 at 7.5 minutes. The systemic and renal physiologic effects of high-dose intravenous Gd-DOTA on the kidney reflects a nonspecific, osmotically induced alteration. These data suggest that the main systemic and renal physiologic actions of Gd-DOTA are a nonspecific response to agent osmolality that is similar qualitatively to conventional, water-soluble contrast media.
authors.affiliation: Department of Radiology, University of Rochester Medical Center, New York.
authors.forename: R W
authors.initials: RW
authors.lastname: Katzberg
authors.forename: L G
authors.initials: LG
authors.lastname: Sahler
authors.forename: S W
authors.initials: SW
authors.lastname: Duda
authors.forename: T W
authors.initials: TW
authors.lastname: Morris
authors.forename: B A
authors.initials: BA
authors.lastname: McKenna
authors.forename: R C
authors.initials: RC
authors.lastname: Pabico
authors.forename: W L
authors.initials: WL
authors.lastname: Niedrach
authors.forename: F W
authors.initials: FW
authors.lastname: Tonetti
mesh_terms: D000818:Animals; D001794:Blood Pressure / Q000187:drug effects; D003287:Contrast Media / Q000008:administration & dosage / Q000633:toxicity*; D004285:Dogs; D005260:Female; D005682:Gadolinium; D005919:Glomerular Filtration Rate / Q000187:drug effects; D006571:Heterocyclic Compounds / Q000008:administration & dosage / Q000633:toxicity*; D007275:Injections, Intravenous; D007668:Kidney / Q000187:drug effects* / Q000502:physiology; D008279:Magnetic Resonance Imaging; D008297:Male; D009942:Organometallic Compounds / Q000008:administration & dosage / Q000633:toxicity*; D012079:Renal Circulation / Q000187:drug effects
chemical_list: D003287:Contrast Media; D006571:Heterocyclic Compounds; D009942:Organometallic Compounds; C050823:gadolinium 1,4,7,10-tetraazacyclododecane-N,N',N'',N'''-tetraacetate; D005682:Gadolinium