Renal function and cardiac angiography.
OBJECTIVE
To study the effect of non-ionic contrast medium on renal function in children with cardiovascular disease.


METHODS
Analysis of renal function in 98 children with cardiovascular disease before and after the use of Iopamidol, Iohexol, and Ioversol was done for angiography. Serum creatinine (s-Cre), urinary N-acetyl-beta-D-glucosaminase (u-NAG), urinary beta 2-microglobulin (u-BMG), and urinary alpha 1-microglobulin (u-AMG) levels were evaluated.


RESULTS
Although s-Cre levels remained unchanged, u-NAG/Cre, u-AMG/Cre and u-BMG/Cre significantly increased 12 hours after angiography. Levels of u-NAG/Cre, u-BMG/Cre, and u-AMG/Cre after angiography were significantly higher in neonates and infants (age< 12-months, n=32) than in children (age>1-year, n=61), in patients with more than 5 ml/kg of contrast medium (n=25) than in those with less than 5 ml/kg (n=70) and in cyanotic patients (n=13) than in non-cyanotic (n=80) patients.


CONCLUSIONS
Transient renal tubular dysfunction occurred in all of these three non-ionic contrast mediums. Although renal tubular function was intact on a long-term basis, one should be careful of contrast medium-induced nephropathy, especially in neonates and infants, in patients receiving more than 5 ml/kg of contrast mediums in total, and in patients with cyanotic heart disease in using non-ionic contrast mediums.
Niboshi
Ayumi
A
Department of Pediatric Cardiology and Nephrology, Kyoto Prefectural University of Medicine Graduate School of Medical Science, Kawaramachi-Hirokoji, Kamikyo-ku Kyoto, Japan.
Nishida
Masashi
M
Itoi
Toshiyuki
T
Shiraishi
Isao
I
Hamaoka
Kenji
K
D000293:Adolescent; D006328:Cardiac Catheterization / Q000009:adverse effects*; D002648:Child; D002675:Child, Preschool; D003287:Contrast Media / Q000009:adverse effects*; D003490:Cyanosis / Q000209:etiology; D006331:Heart Diseases / Q000150:complications / Q000000981:diagnostic imaging*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007472:Iohexol / Q000009:adverse effects; D007479:Iopamidol / Q000009:adverse effects; D007674:Kidney Diseases / Q000139:chemically induced* / Q000652:urine; D011859:Radiography; D014283:Triiodobenzoic Acids / Q000009:adverse effects; D014556:Urine / Q000737:chemistry
D003287:Contrast Media; D014283:Triiodobenzoic Acids; D007472:Iohexol; D007479:Iopamidol; C054871:ioversol