Shyh T P, Friedman E A
Department of Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
Nephron. 1990;55(2):170-5. doi: 10.1159/000185947.
We studied the effect of radiographic contrast media on renal function in both streptozotocin-induced diabetic rats and normoglycemic rats with reduced renal functional mass. Male Sprague-Dawley induced-diabetic rats and weight-matched controls were divided into unilaterally nephrectomized and intact groups prior to an intravenous challenge with sodium diatrizoate (Urografin) at two dose levels, 1,300 and 2,600 mg iodine/kg. Serum creatinine concentration did not change on the 1st and 3rd day after a dose of 1,300 mg/kg of iodine in normal or induced-diabetic rats. Consequent to a dose of 2,600 mg/kg of iodine, induced-diabetic rats had a significant increase in serum creatinine levels to 0.9 +/- 0.45 mg/dl (control 0.68 +/- 0.11 mg/dl). The observed increase in serum creatinine concentration after treatment with sodium diatrizoate was significantly correlated with the degree of hyperglycemia, but not with prior unilateral nephrectomy. Unilateral nephrectomy, prior to administration of sodium diatrizoate did not potentiate the risk of radiocontrast agent injury in induced-diabetic rats. From these findings, we infer that: (1) streptozotocin-induced diabetes in the rat confers a risk for the development of radiocontrast-induced acute renal failure and (2) as judged by the rise in serum creatinine concentration after exposure, there is an increased risk of acute renal failure associated with a higher dose of radiocontrast material.
我们研究了放射造影剂对链脲佐菌素诱导的糖尿病大鼠和肾功能降低的正常血糖大鼠肾功能的影响。雄性斯普拉格-道利诱导糖尿病大鼠和体重匹配的对照组在静脉注射两种剂量水平（1300和2600毫克碘/千克）的泛影酸钠（优维显）之前，被分为单侧肾切除组和完整组。在给予1300毫克/千克碘剂量后第1天和第3天，正常或诱导糖尿病大鼠的血清肌酐浓度没有变化。在给予2600毫克/千克碘剂量后，诱导糖尿病大鼠的血清肌酐水平显著升高至0.9±0.45毫克/分升（对照组为0.68±0.11毫克/分升）。用泛影酸钠治疗后观察到的血清肌酐浓度升高与高血糖程度显著相关，但与先前的单侧肾切除无关。在给予泛影酸钠之前进行单侧肾切除并没有增加诱导糖尿病大鼠发生放射造影剂损伤的风险。从这些发现中，我们推断：（1）链脲佐菌素诱导的大鼠糖尿病会增加发生放射造影剂诱导的急性肾衰竭的风险；（2）根据接触后血清肌酐浓度的升高判断，较高剂量的放射造影剂会增加急性肾衰竭的风险。
