Assessment of Renal Function in the Early Stages of Nephrotoxicity Induced by Iodinated Contrast Media

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Abstract

To determine whether there are early renal function parameters (RFP) which can be monitored to rapidly detect nephrotoxicity induced by contrast media (CM), we observed RFP in 16 patients with normal renal function before and after administration of CM. Forty-eight hours after diatrizoate meglumine administration, blood urea nitrogen (BUN) and serum creatinine (SCr) increased (p < 0.05). In all patients, acute tubular damage was revealed by early urinary RFP. Increases in levels of serum angiotensin-I-converting enzyme (ACE), β2-microglobulin (β2M) and urinary albumin (Alb) were associated with alterations in glomerular function. The changes in early RFP occurred earlier than those of BUN and SCr. The present study demonstrates that serum ACE, β2M, urinary Alb, γ-glutamyl-transpeptidase and N-acetyl-β- D -glucosidase are sensitive parameters for the early assessment of subclinical nephrotoxicity induced by CM.

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Angiotensin I-converting enzyme activity in puromycin aminonucleoside-nephrotic syndrome

Ana Elena Arévalo, María Ibarra-Rubio, Cristino Cruz … (1990)

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Transient glomerular proteinuria, enzymuria, and nephrotoxic reaction induced by radiocontrast media.

Y Nouaille, G Lachâtre, G Nicot … (1984)

Contrast nephropathy is a recognized complication of arteriographic procedures; usually, it consists of a mild deterioration of renal function. In an attempt to understand better the mechanisms involved, we conducted a prospective study before and after arteriography that monitored the urinary elimination of high- and low-molecular weight proteins, the urinary activity of tubular enzymes, and renal clearances of 27 patients. We detected a noticeable and transient nonselective proteinuria of glomerular origin together with moderate signs of tubular damage and a stable renal function. We did not identify any risk factor. Contrast media may alter the disposition of charges along the glomerular filtering membrane in a way that promotes proteinuria; consequently, the massive flow of proteins may injure the tubular cells.