PURPOSE: To determine if depression of creatinine clearance after administration of contrast medium may be prevented with theophylline. MATERIALS AND METHODS: A nonionic, low-osmolality contrast medium (iopamidol) or an ionic, high-osmolality contrast medium (sodium diatrizoate) was administered to 93 patients. Before the examination, these patients were given theophylline or a placebo orally. There were also 30 patients who received anadenosine-uptake inhibitor (dipyridamole). Creatinine clearance and urinary adenosine levels were measured before and after angiography. RESULTS:Creatinine clearance decreased 18% +/- 4 in the placebo-iopamidol group but did not decrease in the theophylline group; urinary adenosine increased 67% +/- 7. Creatinine clearance decreased 42% +/- 5 in the placebo-sodium diatrizoate group and decreased 24% +/- 3 in the theophylline group; urinary adenosine increased 119% +/- 8. In the dipyridamole group in which iopamidol was given, urinary adenosine increased 96% +/- 7 and creatinine clearance decreased 37% +/- 5. CONCLUSION: Intrarenal adenosine can be implicated in the pathogenesis of hypertonic contrast medium nephrotoxicity.
RCT Entities:
PURPOSE: To determine if depression of creatinine clearance after administration of contrast medium may be prevented with theophylline. MATERIALS AND METHODS: A nonionic, low-osmolality contrast medium (iopamidol) or an ionic, high-osmolality contrast medium (sodium diatrizoate) was administered to 93 patients. Before the examination, these patients were given theophylline or a placebo orally. There were also 30 patients who received an adenosine-uptake inhibitor (dipyridamole). Creatinine clearance and urinary adenosine levels were measured before and after angiography. RESULTS:Creatinine clearance decreased 18% +/- 4 in the placebo-iopamidol group but did not decrease in the theophylline group; urinary adenosine increased 67% +/- 7. Creatinine clearance decreased 42% +/- 5 in the placebo-sodium diatrizoate group and decreased 24% +/- 3 in the theophylline group; urinary adenosine increased 119% +/- 8. In the dipyridamole group in which iopamidol was given, urinary adenosine increased 96% +/- 7 and creatinine clearance decreased 37% +/- 5. CONCLUSION: Intrarenal adenosine can be implicated in the pathogenesis of hypertonic contrast medium nephrotoxicity.
Authors: John C O'Horo; Douglas R Osmon; Omar M Abu Saleh; Jasmine R Marcelin; Kamel A Gharaibeh; Abdurrahman M Hamadah; Amelia K Barwise; Bryce M Kayhart; Jennifer S McDonald; Robert J McDonald; Nelson Leung Journal: Antimicrob Agents Chemother Date: 2017-07-25 Impact factor: 5.191
Authors: Michael Joannidis; Wilfred Druml; Lui G Forni; A B Johan Groeneveld; Patrick Honore; Heleen M Oudemans-van Straaten; Claudio Ronco; Marie R C Schetz; Arend Jan Woittiez Journal: Intensive Care Med Date: 2010-03 Impact factor: 17.440