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Pathophysiology of contrast medium–induced nephropathy

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Presentation on theme: "Pathophysiology of contrast medium–induced nephropathy"— Presentation transcript:

1 Pathophysiology of contrast medium–induced nephropathy
Pontus B. Persson, Peter Hansell, Per Liss  Kidney International  Volume 68, Issue 1, Pages (July 2005) DOI: /j x Copyright © 2005 International Society of Nephrology Terms and Conditions

2 Figure 1 Osmolality and viscosity for I-concentration of 300mg/mL. Blood viscosity refers to prearteriolar values. Viscosity and osmolality values taken from information provided by the respective distributor. *In case of Iodixanol the viscosity value for 300mg I/mL was extrapolated from the values of the 150, 270, and 320mg I/mL solutions. The osmolality of Iodixanol is constant for all three concentrations. Kidney International  , 14-22DOI: ( /j x) Copyright © 2005 International Society of Nephrology Terms and Conditions

3 Figure 2 Medullary hypoxia induced by contrast media [ioxaglate (▪), iopromide (♦), and iotrolan (▾)] in comparison to Ringer's solution (▵). Reduction in pO2 is greatest for iotrolan (iso-osmolal nonionic dimer) followed by ioxaglate (low-osmolal ionic dimer). Iopromide (low-osmolal monomer) had the least effect of the contrast media (from Liss et al, 1998, with permission). Kidney International  , 14-22DOI: ( /j x) Copyright © 2005 International Society of Nephrology Terms and Conditions

4 Figure 3 Flow chart of mechanisms linking fluid osmolality to renal damage. GFR is glomerular filtration rate. Kidney International  , 14-22DOI: ( /j x) Copyright © 2005 International Society of Nephrology Terms and Conditions

5 Figure 4 Altered mitochondrial function in a proximal tubular cell line as determined by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) reduction (24-hour treatment). A comparison of the effects of various contrast media on MTT reduction reveal significant differences from one another. The least influence was found by the low-osmolar agents, followed by the iso-osmolar contrast media (Iodixanol). The ionic substances showed the greatest effect (from Hardieck et al, 2001, with permission). Kidney International  , 14-22DOI: ( /j x) Copyright © 2005 International Society of Nephrology Terms and Conditions


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