Toxicology Unit, University of Salamanca, 37007 Salamanca, Spain.
Institute of Biomedical Research of Salamanca (IBSAL), 37007 Salamanca, Spain.
Int J Mol Sci. 2019 Oct 8;20(19):4961. doi: 10.3390/ijms20194961.
Iodinated contrast media (CM) are the leading cause of acute renal failure of toxic origin. Between 21% and 50% of patients that receive them develop contrast-induced nephropathy (CIN). All prophylactic measures used so far have failed to provide effective prevention. Since oxidative stress is involved in the damage, a possible preventive strategy could be the administration of antioxidant substances, such as quercetin. This compound has shown renoprotective effects in experimental studies. The aim of this study was to evaluate whether quercetin may be helpful in preventing CIN in patients undergoing coronary catheterization. A clinical phase II study was conducted. Patients were distributed in two groups, namely, CM (patients who only received contrast media) and CM+Q (patients who were pretreated with quercetin orally for 3-5 days). Results showed less incidence of CIN in the CM+Q group, possibly due to glomerular protection, evidenced by a lower increase in serum creatinine and albuminuria; and a lower decrease in the glomerular filtration rate (GFR). Furthermore, in this group, the relative risk of developing CIN observed in patients that received a high dose of contrast media was inferior. In conclusion, this is the first study that demonstrates that quercetin is a promising safe candidate in preventing CIN.
碘造影剂（CM）是毒理性急性肾衰竭的主要原因。在接受 CM 的患者中，有 21%至 50%会发生对比剂肾病（CIN）。迄今为止，所有预防措施都未能提供有效的预防。由于氧化应激与损伤有关，一种可能的预防策略可能是给予抗氧化物质，如槲皮素。这种化合物在实验研究中显示出了肾脏保护作用。本研究旨在评估槲皮素是否有助于预防接受冠状动脉造影的患者发生 CIN。进行了一项临床二期研究。患者分为两组，即 CM 组（仅接受造影剂的患者）和 CM+Q 组（在接受造影剂前用槲皮素口服预处理 3-5 天的患者）。结果显示 CM+Q 组 CIN 的发生率较低，这可能是由于肾小球保护作用所致，表现为血清肌酐和蛋白尿增加较少；肾小球滤过率（GFR）下降较少。此外，在该组中，观察到接受高剂量造影剂的患者发生 CIN 的相对风险较低。总之，这是第一项证明槲皮素是预防 CIN 的一种有前途的安全候选药物的研究。
