Urinary excretion of vasoactive factors following contrast media exposure in humans.
BACKGROUND
Radiographic contrast media (CM) induce renal vasoconstriction and may initiate induced nephropathy. Endothelin (ET), a vasoconstrictor, and nitric oxide (NO), a vasodilator, which are synthesized in the kidney by the vascular endothelium as well as by tubular epithelial and glomerular mesangial cells, are key modulators of renal circulation after CM administration. Intravascular CM, in addition, induces pronounced diuresis and natriuresis. The aim of the present study was to evaluate and compare changes in endogenous vasoactive mediators and contrast-induced natriuresis after CM administration.


METHODS
Diagnostic angiographic procedures were performed in 14 patients (9 males and 5 females) using the non-ionic CM Iopamidol. Before and immediately after angiography, venous blood and urine samples were obtained. The urinary excretion of ET-1 and nitrates/nitrites (NOx), and the fractional excretion of sodium (FENa) were measured and analyzed.


RESULTS
The urinary excretion of both ET-1 and NOx increased significantly (p < 0.05) after angiography, and urinary ET-1 and NOx excretion was correlated with an increase in FENa (p < 0.05).


CONCLUSIONS
Exposure to CM in humans is associated with an increase in urinary ET and NOx. The excretion of sodium following CM administration is associated with an increase in urinary ET and NOx. ET and NO might be important in the renal change in humans after CM administration.
Murakami
Ryusuke
R
Department of Radiology, Nippon Medical School, Tokyo, Japan. rywakana@nms.ac.jp
Kumazaki
Tatsuo
T
Tajima
Hiroyuki
H
Hayashi
Hiromitsu
H
Kuwako
Tomoyuki
T
Hakozaki
Kenta
K
Kiriyama
Tomonari
T
D000368:Aged; D003287:Contrast Media / Q000009:adverse effects*; D003404:Creatinine / Q000097:blood; D019332:Endothelin-1 / Q000652:urine*; D005260:Female; D006801:Humans; D007674:Kidney Diseases / Q000139:chemically induced; D008297:Male; D008875:Middle Aged; D009318:Natriuresis / Q000187:drug effects*; D009569:Nitric Oxide / Q000652:urine*; D014661:Vasoconstriction / Q000187:drug effects
D003287:Contrast Media; D019332:Endothelin-1; D009569:Nitric Oxide; D003404:Creatinine