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碘化造影剂对慢性高血糖和慢性肾脏病大鼠肾功能及血流动力学的影响

Impact of Iodinated Contrast on Renal Function and Hemodynamics in Rats with Chronic Hyperglycemia and Chronic Kidney Disease.

作者信息

Fernandes Sheila Marques, Martins Daniel Malisani, da Fonseca Cassiane Dezoti, Watanabe Mirian, Vattimo Maria de Fátima Fernandes

机构信息

Experimentation Laboratory in Animal Model, School of Nursing, University of São Paulo, São Paulo, Brazil.

Experimentation Laboratory in Animal Model, School of Nursing, University of São Paulo, São Paulo, Brazil; Department Medical-Surgical Nursing, School of Nursing, University of São Paulo, São Paulo, Brazil.

出版信息

Biomed Res Int. 2016;2016:3019410. doi: 10.1155/2016/3019410. Epub 2016 Feb 29.

Abstract

Iodinated contrast (IC) is clinically used in diagnostic and interventional procedures, but its use can result in contrast-induced acute kidney injury (CI-AKI). Chronic kidney disease (CKD) and chronic hyperglycemia (CH) are important predisposing factors to CI-AKI. The aim of this study was to investigate the impact of iodinated contrast on the renal function and hemodynamics in rats with chronic hyperglycemia and chronic kidney disease. A total of 30 rats were divided into six groups; Sham: control of chronic renal disease; Citrate: control of chronic hyperglycemia (CH); Nx5/6: rats with 5/6 nephrectomy; Chronic Hyperglycemia: rats receiving Streptozotocin 65 mg/kg; Nx5/6 + IC: rats Nx5/6 received 6 mL/kg of IC; CH + IC: Chronic hyperglycemia rats receiving 6 mL/kg of IC. Renal function (inulin clearance; urinary neutrophil gelatinase-associated lipocalin, NGAL) and hemodynamics (arterial blood pressure; renal blood flow; renal vascular resistance) were evaluated. Iodinated contrast significantly increased urinary NGAL and reduced inulin clearance, while the hemodynamics parameters showed changes in arterial blood pressure, renal blood flow, and renal vascular resistance in both CKD and CH groups. The results suggest that the iodinated contrast in risk factors models has important impact on renal function and hemodynamics. NGAL was confirmed to play a role of highlight in diagnosis of CI-AKI.

摘要

碘化造影剂(IC)在临床诊断和介入操作中使用,但它的使用可导致造影剂诱导的急性肾损伤(CI-AKI)。慢性肾脏病(CKD)和慢性高血糖(CH)是CI-AKI的重要易感因素。本研究的目的是探讨碘化造影剂对慢性高血糖和慢性肾脏病大鼠肾功能及血流动力学的影响。总共30只大鼠被分为六组;假手术组:慢性肾脏病对照组;柠檬酸盐组:慢性高血糖(CH)对照组;5/6肾切除组(Nx5/6):行5/6肾切除术的大鼠;慢性高血糖组:接受65mg/kg链脲佐菌素的大鼠;Nx5/6 + IC组:Nx5/6大鼠接受6mL/kg的IC;CH + IC组:慢性高血糖大鼠接受6mL/kg的IC。评估了肾功能(菊粉清除率;尿中性粒细胞明胶酶相关脂质运载蛋白,NGAL)和血流动力学(动脉血压;肾血流量;肾血管阻力)。碘化造影剂显著增加尿NGAL并降低菊粉清除率,而血流动力学参数显示CKD组和CH组的动脉血压、肾血流量和肾血管阻力均有变化。结果表明,在危险因素模型中碘化造影剂对肾功能和血流动力学有重要影响。NGAL被证实在CI-AKI的诊断中起重要作用。

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