Tubular toxicity is the main renal effect of contrast media.
The aim of this study is to evaluate the effects of contrast media on both tubular and glomerular function. Different parameters of tubular and glomerular function were determined before and at 1, 3, and 5 days after the intravascular administration of contrast media in 100 adult renal patients (plasma creatinine 0.6-10.8 mg/dL, mean: 1.3). Urinary activities of five tubular enzymes (alanine aminopeptidase, gamma-glutamyltransferase, alkaline phosphatase, lactate dehydrogenase, N-acetyl-beta-D-glucosaminidase) increased significantly on the first day after the administration of contrast media, indicating a tubular damage. Glomerular filtration rate and the conventional tests of glomerular function (plasma creatinine, creatinine clearance, and urinary proteins) presented only slight variations after the administration of contrast media. In conclusion, contrast media principally affected the renal tubule (as demonstrated by enzymuria), while their effects on glomerular function were very mild.
Donadio
C
C
Unità di Nefrologia Clinica Medica 2, University of Pisa, Italy.
Tramonti
G
G
Lucchesi
A
A
Giordani
R
R
Lucchetti
A
A
Bianchi
C
C
D000118:Acetylglucosaminidase / Q000652:urine; D000293:Adolescent; D000328:Adult; D000368:Aged; D000410:Alanine Transaminase / Q000652:urine; D000469:Alkaline Phosphatase / Q000652:urine; D003287:Contrast Media / Q000008:administration & dosage / Q000009:adverse effects*; D003404:Creatinine / Q000378:metabolism*; D005260:Female; D005919:Glomerular Filtration Rate / Q000187:drug effects; D006801:Humans; D007262:Infusions, Intravenous; D007678:Kidney Glomerulus / Q000187:drug effects* / Q000378:metabolism / Q000503:physiopathology; D007684:Kidney Tubules / Q000187:drug effects* / Q000201:enzymology / Q000503:physiopathology; D007770:L-Lactate Dehydrogenase / Q000652:urine; D008297:Male; D008875:Middle Aged; D009113:Muramidase / Q000652:urine; D051437:Renal Insufficiency / Q000139:chemically induced* / Q000378:metabolism / Q000503:physiopathology; D005723:gamma-Glutamyltransferase / Q000652:urine
D003287:Contrast Media; D003404:Creatinine; D007770:L-Lactate Dehydrogenase; D005723:gamma-Glutamyltransferase; D000410:Alanine Transaminase; D000469:Alkaline Phosphatase; D009113:Muramidase; D000118:Acetylglucosaminidase