title: Effects of contrast media on renal function in patients with cirrhosis: a prospective study.
abstract: Patients with cirrhosis are frequently submitted to radiological procedures that require the administration of contrast media. Contrast media is a well-known cause of renal failure, particularly in the presence of some predisposing conditions. However, it is not known whether cirrhosis constitutes a risk factor for contrast media-induced renal failure. The aim of this study was to assess the possible nephrotoxicity of contrast media in patients with cirrhosis. In a first protocol, renal function was evaluated with sensitive methods (glomerular filtration rate using iothalamate I 125 clearance and renal plasma flow using iodohippurate I 131 clearance) before and 48 hours after the administration of contrast media in 31 patients with cirrhosis (20 with ascites, 5 with renal failure). Solute-free water clearance, urine sodium, prostaglandins, and markers of tubular damage were also measured. The administration of contrast media was not associated with significant changes in renal function tests, neither in the whole group of patients nor in patients with ascites or renal failure. Urinary prostaglandin E2 and N-acetyl-beta-D-glucosaminidase increased significantly, but sodium and solute-free water excretion remained unchanged. In a second protocol, a different series of 60 patients with cirrhosis and renal failure were examined prospectively. No patient had renal failure due to contrast media. Only in 1 patient with septic shock was contrast media a possible contributing factor. In conclusion, the administration of contrast media is not associated with adverse effects on renal function in patients with cirrhosis. Cirrhosis does not appear to be a risk factor for the development of contrast media-induced nephrotoxicity.
authors.affiliation: Liver Unit, Hospital Clínic, Barcelona, Spain. mguevara@clinic.ub.es
authors.forename: Mònica
authors.initials: M
authors.lastname: Guevara
authors.forename: Glòria
authors.initials: G
authors.lastname: Fernández-Esparrach
authors.forename: Carlo
authors.initials: C
authors.lastname: Alessandria
authors.forename: Aldo
authors.initials: A
authors.lastname: Torre
authors.forename: Carlos
authors.initials: C
authors.lastname: Terra
authors.forename: Xavier
authors.initials: X
authors.lastname: Montañà
authors.forename: Carlos
authors.initials: C
authors.lastname: Piera
authors.forename: Maria Luisa
authors.initials: ML
authors.lastname: Alvarez
authors.forename: Wladimiro
authors.initials: W
authors.lastname: Jiménez
authors.forename: Pere
authors.initials: P
authors.lastname: Ginès
authors.forename: Vicente
authors.initials: V
authors.lastname: Arroyo
mesh_terms: D000118:Acetylglucosaminidase / Q000652:urine; D000328:Adult; D000368:Aged; D003287:Contrast Media / Q000009:adverse effects*; D005260:Female; D005919:Glomerular Filtration Rate / Q000187:drug effects; D006801:Humans; D007668:Kidney / Q000187:drug effects*; D008103:Liver Cirrhosis / Q000150:complications*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012079:Renal Circulation / Q000187:drug effects
chemical_list: D003287:Contrast Media; D000118:Acetylglucosaminidase