Pathogenesis of contrast-induced nephropathy: experimental and clinical observations with an emphasis on the role of osmolality.
Experimental studies suggest that the pathogenesis of contrast media nephrotopathy is due to a combination of renal ischemia and direct tubular epithelial cell toxicity. Clinical studies to date have demonstrated a reduction in clinical contrast nephropathy with the introduction of low-osmolar and, more recently, iso-osmolar contrast media. Numerous experimental studies have examined the role of osmolality per se in the pathogenesis of contrast nephropathy, with conflicting results. Whether iso-osmolar contrast media are the least nephrotoxic iodinated contrast media needs to be determined with large prospective randomized clinical trials.
Rudnick
Michael R
MR
Division of Nephrology, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA.
Goldfarb
Stanley
S
D003287:Contrast Media / Q000009:adverse effects* / Q000737:chemistry*; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D007674:Kidney Diseases / Q000209:etiology* / Q000503:physiopathology*; D009994:Osmolar Concentration
D003287:Contrast Media