Brown P, Haylor J, Morcos S K, Cope G H, el Nahas A M
Department of Diagnostic Imaging, Northern General Hospital NHS Trust, Sheffield, UK.
Br J Radiol. 1992 Nov;65(779):1011-7. doi: 10.1259/0007-1285-65-779-1011.
The mechanism of the nephrotoxicity of water-soluble contrast media (WSCM) remains ill defined. We have studied the effect of diatrizoate on the isolated perfused rat kidney (IPRK). Emphasis was on the effect of low- and high-dose diatrizoate on glomerular filtration rate (GFR), renal perfusate flow (RPF), fractional excretion of albumin (FE Alb) and fractional reabsorption of sodium (FR Na). The addition of diatrizoate to the IPRK led to a dose-dependent biphasic change in RPF and GFR characterized by an initial transient increase followed by a marked and sustained decrease. Diatrizoate induced a diuresis and a parallel increase in urinary sodium excretion (fall of FR Na). Fe Alb was also increased in kidneys exposed to diatrizoate. Electron microscopy of a control kidney showed preservation of cellular architecture, which contrasted with the observed cytoplasmic vacuolation of proximal tubular cells after perfusion with diatrizoate. This study confirms a direct effect of WSCM on the function of the IPRK. In this experimental model, diatrizoate reproduces the effects observed in vivo on GFR and renal perfusion.
水溶性造影剂（WSCM）肾毒性的机制仍不清楚。我们研究了泛影酸盐对离体灌注大鼠肾脏（IPRK）的影响。重点是低剂量和高剂量泛影酸盐对肾小球滤过率（GFR）、肾灌注液流量（RPF）、白蛋白分数排泄率（FE Alb）和钠分数重吸收率（FR Na）的影响。向IPRK中添加泛影酸盐会导致RPF和GFR出现剂量依赖性双相变化，其特征是最初短暂升高，随后显著且持续下降。泛影酸盐引起利尿，并使尿钠排泄平行增加（FR Na下降）。暴露于泛影酸盐的肾脏中Fe Alb也增加。对照肾脏的电子显微镜检查显示细胞结构保存完好，这与用泛影酸盐灌注后观察到的近端肾小管细胞胞质空泡化形成对比。本研究证实了WSCM对IPRK功能的直接影响。在这个实验模型中，泛影酸盐再现了体内观察到的对GFR和肾灌注的影响。
