Vattimo Maria deFátima Fernandes, dos Santos Juliana Guareschi
Departamento de Enfermagem Médico-Cirúrgica da Escola de Enfermagem da Universidade de São Paulo. São Paulo, SP, Brasil.
Graduanda da Escola de Enfermagem da Universidade de São Paulo. Bolsista FAPESP. São Paulo, SP, Brasil.
Rev Esc Enferm USP. 2013 Jun;47(3):722-7. doi: 10.1590/s0080-623420130000300028.
Radiological iodinated contrasts (IC) agents cause acute kidney injury (AKI). To evaluate the renoprotective effect of sodium bicarbonate (Bic) on renal function (creatinine clearance [Clcr], Jaffé, and Clcr mLmin -1 x100 g-1) and the oxidative profile (peroxide excretion, urinary peroxides, urinary malondialdehyde, FOX-2 expression, and thiobarbituric acid reactive substance [TBARS; nmol/mg Cr]) in rats treated with an IC agent. Adult male Wistar rats weighing 250-300 g were treated once daily for 5 days with one of the following treatments: saline (0.9%, 3 mL.kg-1xday-1 intraperitoneally [i.p.]), IC agent (sodium and meglumine ioxitalamate, 3 mL/kg, i.p.), Bic + Saline (3-mL/kg Bic, i.p., 1 h before and after saline treatment), and Bic + IC (3-ml/kg Bic, i.p., 1 h before and after the IC treatment). The IC agent induced AKI, and the antioxidant renoprotective effect of Bic was confirmed (Clcr/TBARS/urinary peroxide: saline group, 0.59+/- 0.03/0.11 +/-0.02/1.29+/- 0.24; Bic+Saline group, 0.58 +/-0.03/0.13+/- 0.02/1.32+/- 0.64; IC group, 0.22 +/- 0.02/0.19 +/- 0.02/4.77 +/- 0.24; Bic +Clgroup, 0.51+/- 0.04/0.13+/- 0.3/1.80+/- 0.04; p<0.05). The protective effect of Bic in the IC-induced AKI was confirmed; hence, Bic administration may be considered as a therapeutic option for patients undergoing IC-enhanced radiography.
放射性碘化造影剂（IC）可导致急性肾损伤（AKI）。为评估碳酸氢钠（Bic）对接受IC剂治疗的大鼠肾功能（肌酐清除率[Clcr]、杰氏法及Clcr mL/min×100 g-1）和氧化状态（过氧化物排泄、尿过氧化物、尿丙二醛、FOX-2表达及硫代巴比妥酸反应物质[TBARS；nmol/mg Cr]）的肾脏保护作用。体重250 - 300 g的成年雄性Wistar大鼠，采用以下治疗方法之一，每天治疗1次，共5天：生理盐水（0.9%，3 mL·kg-1×天-1腹腔注射[i.p.]）、IC剂（碘他拉酸钠和葡甲胺，3 mL/kg，i.p.）、Bic + 生理盐水（3 mL/kg Bic，i.p.，在生理盐水治疗前及后1小时）以及Bic + IC（3 mL/kg Bic，i.p.，在IC治疗前及后1小时）。IC剂诱发了AKI，Bic的抗氧化肾脏保护作用得到证实（Clcr/TBARS/尿过氧化物：生理盐水组，0.59±0.03/0.11±0.02/1.29±0.24；Bic + 生理盐水组，0.58±0.03/0.13±0.02/1.32±0.64；IC组，0.22±0.02/0.19±0.02/4.77±0.24；Bic + IC组，0.51±0.04/0.13±0.3/1.80±0.04；p<0.05）。Bic在IC诱发的AKI中的保护作用得到证实；因此，对于接受IC增强造影的患者，给予Bic可被视为一种治疗选择。
