[Study on free enzymes and proteins in the urine. Report IV: The effects of Iohexol on elderly patients with renal function disorder].
We assessed the nephrotoxicity of a non-ionic contrast medium, Iohexol, in 18 elderly patients. They were divided into two groups. Group 1 consisted of 12 patients with glomerular flow rate (GFR) above 60 ml/min/1.73 m2 (range 69-136; average 96) and group 2 consisted of 6 patients with GFR below 60 ml/min/1.73 m2 (range 38-59; average 49). Urine samples, collected before, immediately after, and on the third and sixth days after drip infused pyeloureterography (DIP) were analyzed for gamma-glutamyl transpeptidase (gamma-GTP), N-acetyl-beta-D-glucosaminidase (NAG), beta 2-microglobulin (beta 2-MG) and albumin. In group 1, immediately after DIP, the urinary excretion of albumin, gamma-GTP and NAG were significantly increased (p < 0.01, p < 0.01, p < 0.01). In group 2, immediately after DIP, the urinary excretion of gamma-GTP and beta 2-MG were significantly increased (p < 0.01, p < 0.1). The gamma-GTP and NAG values in both groups suggest that the damage of proximal tubules cells will not continue for more than 4 days. However, as for the reabsorption of beta 2-MG on proximal tubules, in group 2 the value did not return to the pre DIP level until 6 days after DIP. We believe it is important to postpone injection of non-ionic contrast medium within 6 days of its last usage.
Fukui
J
J
Department of Urology, Osaka City University.
Yasumoto
R
R
Kishimoto
T
T
Kobayakawa
H
H
Gotou
T
T
Eguchi
J
J
Iseki
T
T
Nishio
S
S
D000118:Acetylglucosaminidase / Q000652:urine; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000652:urine; D000419:Albuminuria / Q000652:urine*; D005260:Female; D006801:Humans; D007472:Iohexol / Q000009:adverse effects*; D007668:Kidney / Q000187:drug effects*; D007674:Kidney Diseases / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D001613:beta 2-Microglobulin / Q000652:urine; D005723:gamma-Glutamyltransferase / Q000652:urine
D001613:beta 2-Microglobulin; D007472:Iohexol; D005723:gamma-Glutamyltransferase; D000118:Acetylglucosaminidase