Influence of the viscosity of iodixanol on medullary and cortical blood flow in the rat kidney: a potential cause of Nephrotoxicity.

The aim of the present study was to investigate the effects of four iodinated contrast media on cortical, inner medullary and outer medullary blood flow in the rat kidney by using laser-Doppler flowmetry. The high-osmolar contrast medium diatrizoate did not significantly modify medullary perfusion but moderately decreased the cortical blood flow when injected at a dose of 1600 mg iodine kg(-1). Similar effects were obtained with the low-osmolar contrast media ioxaglate and iobitridol. In contrast, the new iso-osmolar contrast medium iodixanol induced a dose-dependent reduction of perfusion in all regions tested. This effect was accompanied by concomitant hypotension. The reduction of inner medullary and cortical blood flow induced by iodixanol was partially alleviated by heating the solution prior to injection and subsequently reducing its viscosity. In the outer medulla, however, this procedure did not improve blood flow. These results suggest that lowering the viscosity may palliate the harmful effects of iodixanol on the inner medulla and cortex, but may not protect the outer medulla from hypoxic injury.