title: Is contrast medium osmolality a causal factor for contrast-induced nephropathy?
abstract: The exact pathophysiology of contrast-induced nephropathy (CIN) is not fully clarified, yet the osmotic characteristics of contrast media (CM) have been a significant focus in many investigations of CIN. Osmotic effects of CM specific to the kidney include transient decreases in blood flow, filtration fraction, and glomerular filtration rate. Potentially significant secondary effects include an osmotically induced diuresis with a concomitant dehydrating effect. Clinical experiences that have compared the occurrence of CIN between the various classes of CM based on osmolality have suggested a much less than anticipated advantage, if any, with a lower osmolality. Recent animal experiments actually suggest that induction of a mild osmotic diuresis in association with iso-osmolar agents tends to offset potentially deleterious renal effects of high viscosity-mediated intratubular CM stagnation.
authors.affiliation: Department of Radiology and Radiological Science, Medical University of South Carolina, 25 Courtenay Drive MSC 226, Charleston, SC 29425, USA ; Department of Diagnostic and Interventional Radiology, Johann Wolfgang Goethe University Hospital, 60590 Frankfurt am Main, Germany.
authors.forename: Andreas M
authors.initials: AM
authors.lastname: Bucher
authors.affiliation: Department of Radiology and Radiological Science, Medical University of South Carolina, 25 Courtenay Drive MSC 226, Charleston, SC 29425, USA ; Department of Radiological Sciences, Oncology and Pathology, University of Rome "Sapienza"-Polo Pontino, Latina, Italy.
authors.forename: Carlo N
authors.initials: CN
authors.lastname: De Cecco
authors.affiliation: Department of Radiology and Radiological Science, Medical University of South Carolina, 25 Courtenay Drive MSC 226, Charleston, SC 29425, USA.
authors.forename: U Joseph
authors.initials: UJ
authors.lastname: Schoepf
authors.affiliation: Department of Radiology and Radiological Science, Medical University of South Carolina, 25 Courtenay Drive MSC 226, Charleston, SC 29425, USA ; Institute for Clinical Radiology, Ludwig-Maximilians-University Hospital, Marchioninistr. 15, 81377 Munich, Germany.
authors.forename: Felix G
authors.initials: FG
authors.lastname: Meinel
authors.affiliation: Department of Radiology and Radiological Science, Medical University of South Carolina, 25 Courtenay Drive MSC 226, Charleston, SC 29425, USA.
authors.forename: Aleksander W
authors.initials: AW
authors.lastname: Krazinski
authors.affiliation: Department of Radiology and Radiological Science, Medical University of South Carolina, 25 Courtenay Drive MSC 226, Charleston, SC 29425, USA.
authors.forename: James V
authors.initials: JV
authors.lastname: Spearman
authors.affiliation: Department of Radiology and Radiological Science, Medical University of South Carolina, 25 Courtenay Drive MSC 226, Charleston, SC 29425, USA.
authors.forename: Andrew D
authors.initials: AD
authors.lastname: McQuiston
authors.affiliation: Department of Radiology and Radiological Science, Medical University of South Carolina, 25 Courtenay Drive MSC 226, Charleston, SC 29425, USA ; Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China.
authors.forename: Rui
authors.initials: R
authors.lastname: Wang
authors.affiliation: Heidelberg Kidney Center, Department of Nephrology, University Hospital Heidelberg, INF 162, 69120 Heidelberg, Germany.
authors.forename: Judith
authors.initials: J
authors.lastname: Bucher
authors.affiliation: Department of Diagnostic and Interventional Radiology, Johann Wolfgang Goethe University Hospital, 60590 Frankfurt am Main, Germany.
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Vogl
authors.affiliation: Department of Radiology and Radiological Science, Medical University of South Carolina, 25 Courtenay Drive MSC 226, Charleston, SC 29425, USA.
authors.forename: Richard W
authors.initials: RW
authors.lastname: Katzberg
mesh_terms: D000818:Animals; D003287:Contrast Media / Q000009:adverse effects* / Q000737:chemistry*; D006801:Humans; D007674:Kidney Diseases / Q000139:chemically induced*; D009994:Osmolar Concentration; D051381:Rats
chemical_list: D003287:Contrast Media