Contrast Media Viscosity versus Osmolality in Kidney Injury : Lessons from Animal Studies
Joint Authors
Seeliger, Erdmann
Persson, Pontus B.
Lenhard, Diana C.
Source
Issue
Vol. 2014, Issue 2014 (31 Dec. 2014), pp.1-15, 15 p.
Publisher
Hindawi Publishing Corporation
Publication Date
2014-02-22
Country of Publication
Egypt
No. of Pages
15
Main Subjects
Abstract EN
Iodinated contrast media (CM) can induce acute kidney injury (AKI).
CM share common iodine-related cytotoxic features but differ considerably with regard to osmolality and viscosity.
Meta-analyses of clinical trials generally failed to reveal renal safety differences of modern CM with regard to these physicochemical properties.
While most trials’ reliance on serum creatinine as outcome measure contributes to this lack of clinical evidence, it largely relies on the nature of prospective clinical trials: effective prophylaxis by ample hydration must be employed.
In everyday life, patients are often not well hydrated; here we lack clinical data.
However, preclinical studies that directly measured glomerular filtration rate, intrarenal perfusion and oxygenation, and various markers of AKI have shown that the viscosity of CM is of vast importance.
In the renal tubules, CM become enriched, as water is reabsorbed, but CM are not.
In consequence, tubular fluid viscosity increases exponentially.
This hinders glomerular filtration and tubular flow and, thereby, prolongs intrarenal retention of cytotoxic CM.
Renal cells become injured, which triggers hypoperfusion and hypoxia, finally leading to AKI.
Comparisons between modern CM reveal that moderately elevated osmolality has a renoprotective effect, in particular, in the dehydrated state, because it prevents excessive tubular fluid viscosity.
American Psychological Association (APA)
Seeliger, Erdmann& Lenhard, Diana C.& Persson, Pontus B.. 2014. Contrast Media Viscosity versus Osmolality in Kidney Injury : Lessons from Animal Studies. BioMed Research International،Vol. 2014, no. 2014, pp.1-15.
https://search.emarefa.net/detail/BIM-465585
Modern Language Association (MLA)
Seeliger, Erdmann…[et al.]. Contrast Media Viscosity versus Osmolality in Kidney Injury : Lessons from Animal Studies. BioMed Research International No. 2014 (2014), pp.1-15.
https://search.emarefa.net/detail/BIM-465585
American Medical Association (AMA)
Seeliger, Erdmann& Lenhard, Diana C.& Persson, Pontus B.. Contrast Media Viscosity versus Osmolality in Kidney Injury : Lessons from Animal Studies. BioMed Research International. 2014. Vol. 2014, no. 2014, pp.1-15.
https://search.emarefa.net/detail/BIM-465585
Data Type
Journal Articles
Language
English
Notes
Includes bibliographical references
Record ID
BIM-465585