Effect of nitrendipine on renal function and on hormonal parameters after intravascular iopromide.
OBJECTIVE
To evaluate the effect of the low-molecular nonionic radiographic contrast agent iopromide (Ultravist) on renal function, vasoactive peptides (angiotensin II, aldosterone, arginine vasopressin, and atrial natriuretic factor (ANF)), and blood pressure, and to evaluate the influence of the calcium antagonist nitrendipine on these parameters. The findings were evaluated in a prospective double-blind and placebo-controlled randomized study.


METHODS
Twenty-six patients undergoing routine aortofemoral arteriography for peripheral atherosclerotic disease were treated with nitrendipine tablets (10 mg) or placebo twice daily for a week. Angiography was performed on the fifth day of medication. Efficacy variables were determined on the day before and 2 days after arteriography. The glomerular filtration rate and renal plasma flow were measured by the constant infusion technique. Renal tubular function was estimated from the clearance of lithium. Hormones were measured by radioimmunoassays.


RESULTS
Arteriography with iopromide did not change renal function. No differences between the nitrendipine and placebo groups were found in renal hemodynamics, tubular sodium handling, or blood pressure. Nitrendipine changed ANF (26.1%) compared to placebo (1.5%), whereas the other hormones were not affected.


CONCLUSIONS
The use of iopromide for angiography did not affect renal function in normotensive patients with peripheral atherosclerotic disease. Short-term treatment with nitrendipine may lower the plasma levels of ANF but it had no effect on renal function or blood pressure. Treatment with calcium antagonists prior to arteriography with iopromide is not indicated in these patients.
Research Laboratory of Nephrology and Hypertension, Skejby Hospital, Arhus University Hospital, Denmark.
J K
JK
Madsen
J W
JW
Jensen
J
J
Sandermann
N
N
Johannesen
W P
WP
Paaske
M
M
Egeblad
E B
EB
Pedersen
D000328:Adult; D000368:Aged; D001027:Aortography; D001161:Arteriosclerosis / Q000097:blood / Q000000981:diagnostic imaging / Q000503:physiopathology; D002121:Calcium Channel Blockers / Q000494:pharmacology*; D003287:Contrast Media / Q000008:administration & dosage*; D004311:Double-Blind Method; D005260:Female; D005263:Femoral Artery / Q000000981:diagnostic imaging; D006439:Hemodynamics / Q000187:drug effects; D006728:Hormones / Q000097:blood*; D006801:Humans; D007472:Iohexol / Q000008:administration & dosage / Q000031:analogs & derivatives*; D007668:Kidney / Q000187:drug effects* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D009568:Nitrendipine / Q000494:pharmacology*; D011446:Prospective Studies
D002121:Calcium Channel Blockers; D003287:Contrast Media; D006728:Hormones; D007472:Iohexol; C038192:iopromide; D009568:Nitrendipine