Reactive oxygen species and the pathogenesis of radiocontrast-induced nephropathy.
Experimental findings in vitro and in vivo illustrate enhanced hypoxia and the formation of reactive oxygen species (ROS) within the kidney following the administration of iodinated contrast media, which may play a role in the development of contrast media-induced nephropathy. Clinical studies indeed support this possibility, suggesting a protective effect of ROS scavenging or reduced ROS formation with the administration of N-acetyl cysteine and bicarbonate infusion, respectively. Furthermore, most risk factors, predisposing to contrast-induced nephropathy are prone to enhanced renal parenchymal hypoxia and ROS formation. In this review, the association of renal hypoxia and ROS-mediated injury is outlined. Generated during contrast-induced renal parenchymal hypoxia, ROS may exert direct tubular and vascular endothelial injury and might further intensify renal parenchymal hypoxia by virtue of endothelial dysfunction and dysregulation of tubular transport. Preventive strategies conceivably should include inhibition of ROS generation or ROS scavenging.
Heyman
Samuel N
SN
Department of Medicine, Hadassah Hospital, Mt. Scopus and the Hebrew University Medical School, Jerusalem, Israel. heyman@cc.huji.ac.il
Rosen
Seymour
S
Khamaisi
Mogher
M
Idée
Jean-Marc
JM
Rosenberger
Christian
C
D000111:Acetylcysteine / Q000627:therapeutic use; D058186:Acute Kidney Injury / Q000139:chemically induced* / Q000378:metabolism* / Q000517:prevention & control; D000818:Animals; D000975:Antioxidants / Q000627:therapeutic use; D001639:Bicarbonates / Q000627:therapeutic use; D002021:Buffers; D015687:Cell Hypoxia; D003287:Contrast Media / Q000009:adverse effects*; D004730:Endothelium, Vascular / Q000378:metabolism; D016166:Free Radical Scavengers / Q000627:therapeutic use; D006801:Humans; D018384:Oxidative Stress; D017382:Reactive Oxygen Species / Q000378:metabolism*; D012307:Risk Factors
D000975:Antioxidants; D001639:Bicarbonates; D002021:Buffers; D003287:Contrast Media; D016166:Free Radical Scavengers; D017382:Reactive Oxygen Species; D000111:Acetylcysteine