title: Role of adenosine in contrast media-induced acute renal failure in diabetes mellitus.
abstract: Increased release of renal adenosine and stimulation of renal adenosine receptors have been proposed to be major mechanisms in the development of contrast media-induced acute renal failure (CM-ARF). Patients with diabetes mellitus or preexisting renal disease who have reduced renal function have a markedly increased risk to develop CM-ARF. This increased risk to develop CM-ARF in patients with diabetes mellitus is linked to a higher sensitivity of the renal vasculature to adenosine, since experimental studies have shown increased adenosine-induced vasoconstriction in the kidneys of diabetic animals. Furthermore, recent evidence suggests that administration of adenosine receptor antagonists reduces the risk of development of CM-ARF in both diabetic and nondiabetic patients. The purpose of this review is to discuss the role of adenosine in the development of CM-ARF, particularly in the kidneys of diabetic patients, and to evaluate the therapeutic potential of adenosine receptor antagonists in the prevention of CM-ARF. Selective adenosine A1 receptor antagonists may provide a therapeutic tool to prevent CM-ARF in patients with diabetes mellitus and reduced renal function.
authors: Department of Physiology and Biophysics, Mayo Clinic, 200 First St SW, Rochester, MN 55905, USA.
authors: A
authors: A
authors: Pflueger
authors: T S
authors: TS
authors: Larson
authors: K A
authors: KA
authors: Nath
authors: B F
authors: BF
authors: King
authors: J M
authors: JM
authors: Gross
authors: F G
authors: FG
authors: Knox
mesh_terms: D058186:Acute Kidney Injury / Q000139:chemically induced* / Q000150:complications / Q000503:physiopathology / Q000517:prevention & control; D000241:Adenosine / Q000378:metabolism*; D003287:Contrast Media / Q000009:adverse effects*; D048909:Diabetes Complications; D006801:Humans; D009994:Osmolar Concentration; D058915:Purinergic P1 Receptor Antagonists; D018047:Receptors, Purinergic P1 / Q000378:metabolism; D012307:Risk Factors
chemical_list: D003287:Contrast Media; D058915:Purinergic P1 Receptor Antagonists; D018047:Receptors, Purinergic P1; D000241:Adenosine