Evaluating the effects of diclofenac sodium and etodolac on renal hemodynamics with contrast-enhanced ultrasonography: a pilot study.
OBJECTIVE
Contrast-enhanced ultrasonography (CEUS) is a novel approach used for measuring organ perfusion changes. Studies using CEUS to assess the effects of non-steroidal anti-inflammatory drugs (NSAIDs) on renal blood flow (RBF) have not yet been conducted. We aimed to evaluate the effects of NSAIDs on the renal hemodynamics of healthy subjects with CEUS.


METHODS
We performed CEUS using the bolus injection method in a total of 10 healthy subjects. Measurements were completed over two study days in a randomized, crossover manner. On each study day, CEUS was performed twice, before and after the administration of NSAIDs. Subjects received an injection of contrast medium and images were recorded. A region-of-interest (ROI) was selected within the renal cortex, signal intensity in the ROI of the kidney was measured and a time-intensity curve (TIC) was automatically generated with attached software.


RESULTS
The mean (±SD) peak intensity decreased significantly after an administration of diclofenac sodium (from 26.0 × 10(-4) ± 17.4 × 10(-4) AU to 19.2 × 10(-4) ± 12.0 × 10(-4) AU; P = 0.022), but not significantly with etodolac (from 26.5 × 10(-4) ± 9.7 × 10(-4) AU to 25.9 × 10(-4) ± 20.8 × 10(-4) AU; P = 0.474). The mean (±SD) percent reduction in intensity following diclofenac sodium administration was significantly reduced compared with etodolac administration (22.2 ± 20.5 % vs. 3.4 ± 8.9 %, P = 0.037).


CONCLUSIONS
These finding suggests that diclofenac sodium (P = 0.022), but not etodolac (P = 0.474), affects renal hemodynamics even in healthy subjects.
Division of Endoscopy and Ultrasound, Department of Clinical Pathology and Laboratory Medicine, Kawasaki Medical School, 577 Matsushima, Kurashiki, Okayama 701-0192, Japan. Imamura@med.kawasaki-m.ac.jp
Hiroshi
H
Imamura
Jiro
J
Hata
Ai
A
Iida
Noriaki
N
Manabe
Ken
K
Haruma
D000328:Adult; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage*; D018592:Cross-Over Studies; D052246:Cyclooxygenase 2 Inhibitors / Q000008:administration & dosage*; D004008:Diclofenac / Q000008:administration & dosage*; D017308:Etodolac / Q000008:administration & dosage*; D005260:Female; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D007668:Kidney / Q000098:blood supply / Q000000981:diagnostic imaging / Q000187:drug effects; D008297:Male; D012079:Renal Circulation / Q000187:drug effects*; D014463:Ultrasonography
D000894:Anti-Inflammatory Agents, Non-Steroidal; D052246:Cyclooxygenase 2 Inhibitors; D004008:Diclofenac; D017308:Etodolac