[半剂量荧光素钠造影剂对轻中度慢性肾脏病患者肝肾功能的影响：一项回顾性队列研究]

[Effect of half-dose fluorescein sodium contrast agent on liver and kidney functions in patients with mild to moderate chronic kidney disease: a retrospective cohort study].

作者信息

Li Y, Shi L, Jia L, Zhang H

机构信息

Senior Department of Ophthalmology, the Third Medical Center of PLA General Hospital, Beijing 100853, China.

Southern Medical Branch of PLA General Hospital, Beijing 100036, China.

出版信息

Nan Fang Yi Ke Da Xue Xue Bao. 2021 Aug 31;41(9):1436-1438. doi: 10.12122/j.issn.1673-4254.2021.09.22.

DOI:10.12122/j.issn.1673-4254.2021.09.22

PMID:34658362

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8526319/

Abstract

OBJECTIVE

To observe the effect of half-dose fluorescein sodium (FINa) contrast agent on liver and kidney functions in patients with mild to moderate (stage 1 to 3) chronic kidney disease (CKD) and the incidence of contrast-induced nephropathy (CIN).

METHODS

Seventy-seven patients (including 50 male and 27 female patients with an mean age of 53.5±9.6 years) with CKD with normal renal function or mild to moderate abnormalities underwent fundus fluorescein angiography (FFG) examination with half-dose FINa. Liver function, blood creatinine (Scr), blood urea nitrogen (BUN), urine β2 microglobulin (β2-MG), and glomerular filtration rate (eGFR) of the patients were measured within 3 days before intravenous injection of the contrast agent and at 1, 3, 7, and 30±1 days after the operation to analyze the effect of the contrast agent on renal function.

RESULTS

Among the 77 patients, CIN occurred only in one case with an incidence rate of 1.30%. BUN, urine β2- MG, or rapid microalbumin/creatinine did not vary significantly after FFA in these patients. Scr levels showed no significant increments at 1 day and 7 days after FFA, but increased significantly at 3 days (24.6±2.3; < 0.01) and 30 days (16.0±21.7; < 0.05). Urine NAG enzymes and urinary osmolality were significantly reduced at 1, 3, 7, and 30 days after FFA ( < 0.01). The eGFR decreased significantly to 10.23±0.62 at 3 days after FAG and became normal at 7 days. Urine albumin level decreased significantly at 1, 3, 7, and 30 days after FFA ( < 0.01). Blood β2-MGFAG level increased significantly at 3 days after FFA (0.314± 0.121; < 0.01), but decreased to 0.134±0.143 at 7 days ( < 0.05). The level transaminase decreased significantly at 3 and 7 days after FFA ( < 0.01).

CONCLUSION

Half-dose of FINa has no significant effect on liver function and has only minimal effect on kidney function in patients with mild to moderate CKD, and FFA with half-dose FINa can therefore be safely performed in these patients.

摘要

目的

观察半量荧光素钠（FINa）造影剂对轻至中度（1至3期）慢性肾脏病（CKD）患者肝肾功能的影响及造影剂肾病（CIN）的发生率。

方法

77例肾功能正常或轻度至中度异常的CKD患者（包括50例男性和27例女性，平均年龄53.5±9.6岁）接受了半量FINa眼底荧光血管造影（FFG）检查。在静脉注射造影剂前3天内以及术后1、3、7和30±1天测量患者的肝功能、血肌酐（Scr）、血尿素氮（BUN）、尿β2微球蛋白（β2-MG）和肾小球滤过率（eGFR），以分析造影剂对肾功能的影响。

结果

77例患者中，仅1例发生CIN，发生率为1.30%。这些患者FFA后BUN、尿β2-MG或快速微量白蛋白/肌酐无明显变化。FFA后1天和7天Scr水平无明显升高，但在3天（24.6±2.3；<0.01）和30天（16.0±21.7；<0.05）时显著升高。FFA后1、3、7和30天尿NAG酶和尿渗透压显著降低（<0.01）。FAG后3天eGFR显著降至10.23±0.62，7天时恢复正常。FFA后1、3、7和30天尿白蛋白水平显著降低（<0.01）。FFA后3天血β2-MGFAG水平显著升高（0.314±0.121；<0.01），但7天时降至0.134±0.143（<0.05）。FFA后3天和7天转氨酶水平显著降低（<0.01）。