Matsunami Tamaki, Hino Kazuo, Dosho Rie, Miyatake Sho, Ebisu Goro, Kuwatsuru Ryohei
Department of Radiology, Juntendo University Shizuoka Hospital, Izunokuni, Japan.
Otsuka Pharmaceutical Factory, Inc., Tokushima, Japan.
Jpn J Radiol. 2017 Apr;35(4):190-196. doi: 10.1007/s11604-017-0620-4. Epub 2017 Feb 15.
To compare oral rehydration solution (ORS) with saline infusion for preventing contrast-induced nephropathy (CIN) in a rat model.
Adult male Sprague-Dawley rats (310-360 g) received intravenous indomethacin (10 mg/kg), N -nitro-L-arginine methyl ester (10 mg/kg), and iohexol (10 mL/kg) to induce acute contrast-induced renal injury (CIN group); control rats received saline only. For hydration, rats received either continuous infusion (20 mL/kg/h) of saline or three oral doses (20 mL/kg each) of ORS. Acute renal injury was evaluated by assaying urine collected for 24 h beginning 2 h before the contrast injection, evaluating blood taken 22 h after the contrast injection, and examining the kidneys histopathologically.
Hydration with saline prevented only the contrast-induced increase in plasma creatinine, whereas ORS prevented deleterious changes in plasma creatinine, blood urea nitrogen, and creatinine clearance as well as in urinary protein, albumin, and N-acetyl-D-glucosaminidase concentrations. Histopathologic changes noted in the CIN group were diminished in both saline and ORS groups.
Both intravenous saline administration and oral hydration with ORS decreased the severity of CIN. Hydration with ORS was comparable to intravenous saline infusion in preventing CIN-associated abnormalities.
在大鼠模型中比较口服补液盐（ORS）与静脉输注生理盐水预防对比剂肾病（CIN）的效果。
成年雄性Sprague-Dawley大鼠（310 - 360 g）静脉注射吲哚美辛（10 mg/kg）、N-硝基-L-精氨酸甲酯（10 mg/kg）和碘海醇（10 mL/kg）以诱导急性对比剂所致肾损伤（CIN组）；对照大鼠仅接受生理盐水。为进行补液，大鼠接受持续静脉输注生理盐水（20 mL/kg/h）或分三次口服ORS（每次20 mL/kg）。在注射对比剂前2小时开始收集24小时尿液，在注射对比剂后22小时采集血液，通过检测这些样本以及对肾脏进行组织病理学检查来评估急性肾损伤。
静脉输注生理盐水仅预防了对比剂所致的血浆肌酐升高，而ORS预防了血浆肌酐、血尿素氮和肌酐清除率以及尿蛋白、白蛋白和N-乙酰-D-氨基葡萄糖苷酶浓度的有害变化。CIN组中观察到的组织病理学变化在生理盐水组和ORS组中均有所减轻。
静脉输注生理盐水和口服ORS补液均降低了CIN的严重程度。在预防CIN相关异常方面，ORS补液与静脉输注生理盐水效果相当。
