Bosio M, Bissoli F, Vignati G, Fiori M G
Division of Paediatrics, Fornaroli Hospital, Magenta, Italy.
Pediatr Nephrol. 1990 May;4(3):240-4. doi: 10.1007/BF00857663.
Twenty-seven children [2 with chronic renal failure (CRF)] with reflux or obstructive nephropathy underwent intravenous urography with iopamidol 370, a nonionic contrast medium 1 (CM), osmolality 796 mosmol/kg, for renal growth evaluation. Mean iopamidol dosing was 1.69 ml/kg (range 1.22-2.42); the 2 children with CRF received 2 and 2.42 ml/kg respectively. One hour after infusion a significant decrease in haematocrit, haemoglobin, plasma sodium (Na+), chloride (Cl-), renin activity and aldosterone was observed, consistent with a possible plasma volume expansion due to the slightly hypertonic CM. At the same time there was a significant increase in fractional excretion of Na+, Cl- and potassium, probably due to the haemodynamic effects and tubular response to a substance acting as on osmotic diuretic. The -24 to +48 h monitoring of albuminuria, beta-2-microglobulin excretion, and in 4 children excretion of N-acetyl-beta-glucosaminidase and alanine-aminopeptidase did not show any relevant nephrotoxicity. No untoward effect of clinical relevance was observed.
27名患有反流或梗阻性肾病的儿童[2名患有慢性肾衰竭（CRF）]接受了静脉肾盂造影，使用碘帕醇370（一种非离子型造影剂1（CM），渗透压796 mosmol/kg）进行肾脏生长评估。碘帕醇的平均给药剂量为1.69 ml/kg（范围为1.22 - 2.42）；2名患有CRF的儿童分别接受了2和2.42 ml/kg的剂量。输注后1小时，观察到血细胞比容、血红蛋白、血浆钠（Na+）、氯（Cl-）、肾素活性和醛固酮显著下降，这与由于轻度高渗造影剂可能导致的血浆容量扩张一致。同时，Na+、Cl-和钾的分数排泄显著增加，这可能是由于血流动力学效应以及肾小管对作为渗透性利尿剂的物质的反应。对蛋白尿、β2-微球蛋白排泄以及4名儿童的N-乙酰-β-葡萄糖苷酶和丙氨酸氨基肽酶排泄进行的-24至+48小时监测未显示任何相关的肾毒性。未观察到具有临床相关性的不良影响。
