Endothelin (ET-1) is involved in the contrast media induced nephrotoxicity in children with congenital heart disease.
In 77 children with congenital heart disease urinary endothelin-1 (ET-1), an indicator of intrarenal endothelin release, was compared to urinary excretion of total protein, albumin, immunoglobuline G (IgG), alpha 1-microglobuline (alpha 1-MG), N-acetyl-beta-D-glucosaminidase (NAG) and villin. Urine samples were collected the day before and immediately after cardiac angiography with high (Conray 70; n = 56; CON) or low osmolality contrast media (Solutrast 300; n = 21; SOL) to assess the relationship between urinary endothelin and glomerular and tubular nephrotoxicity of contrast media. The children were further subdivided according to age: less than 1 year-CON 1 (n = 20); SOL 1 (n = 12) and 1-18 years CON 2 (n = 36); SOL 2 (n = 9). Results (median): 1. There are no significant changes in total protein-, albumin- and IgG-excretion as parameters of glomerular toxicity. 2. Tubular toxicity of contrast media is shown by significant increase of alpha 1-MG-(10.0 to 23.2 mg/g Crea; p < 0.001), NAG-(5.9 to 9.6 mg/g Crea; p < 0.001) and Villin-excretion (1.0 to 2.0 STS, p < 0.001) in all children. 3. Endothelin excretion (101.0 to 163.0 ng/g Crea, p < 0.001) and concentration (42.5 to 56.0 pg/ml; p < 0.001) were elevated after angiography in all children. 4. The changes in endothelin excretion are correlated to the changes in alpha 1-MG (r = 0.65; p < 0.001) and NAG (r = 0.43, p < 0.001) in all children.(ABSTRACT TRUNCATED AT 250 WORDS)
Hentschel
M
M
Department of Pediatrics, Albert-Ludwigs-University, Freiburg, Germany.
Gildein
P
P
Brandis
M
M
Zimmerhackl
L B
LB
D000293:Adolescent; D000790:Angiocardiography; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D016232:Endothelins / Q000502:physiology / Q000652:urine*; D006330:Heart Defects, Congenital / Q000000981:diagnostic imaging*; D006801:Humans; D007223:Infant; D007479:Iopamidol / Q000009:adverse effects*; D007482:Iothalamate Meglumine / Q000009:adverse effects*; D007674:Kidney Diseases / Q000139:chemically induced* / Q000652:urine; D007684:Kidney Tubules / Q000187:drug effects; D009994:Osmolar Concentration; D011446:Prospective Studies
D016232:Endothelins; D007479:Iopamidol; D007482:Iothalamate Meglumine