Porst H, Mayer R, Clauss W
Urologe A. 1986 Mar;25(2):120-3.
Nephrotoxic effect of ionic and non-ionic contrast media was examined in a doubleblind study by evaluation of serum creatinine, blood urea nitrogen, urine volume, urinary protein excretion and erythrocyturia before and after selective renovasography. In 19 of 22 patients reliable results were obtained. With optimal hydration before and after renovasography no significant differences between both administered contrast media (Rayvist 300 and Omnipaque 300) could be found by evaluation of the aforementioned parameters. In 3 patients with preexistent proteinuria (greater than 200 mg/l) urine protein excretion remained at the same or a lower level after application of the non-ionic contrast medium Omnipaque 300. Three patients with proteinuria tended to increase the proteinuria after administration of the ionic contrast medium (Rayvist 300) up to 48 h after angiography indicating a higher nephrotoxic potential of ionic contrast media in patients with preexistent renal disease. The constant values of urine volume and serum creatinine indicate an absence of clinically relevant nephrotoxicity of both contrast media in this study when administered in well-hydrated patients. This emphasizes the importance of sufficient hydration in prophylaxis of nephrotoxic effects, especially in patients with risk factors.
通过在选择性肾血管造影前后评估血清肌酐、血尿素氮、尿量、尿蛋白排泄和红细胞尿，在一项双盲研究中检测了离子型和非离子型造影剂的肾毒性作用。在22例患者中的19例获得了可靠结果。通过评估上述参数，在肾血管造影前后进行最佳水化的情况下，两种所用造影剂（瑞维显300和欧乃派克300）之间未发现显著差异。在3例既往有蛋白尿（大于200mg/l）的患者中，应用非离子型造影剂欧乃派克300后尿蛋白排泄保持在相同或更低水平。3例蛋白尿患者在给予离子型造影剂（瑞维显300）后，直至血管造影后48小时蛋白尿有增加趋势，表明离子型造影剂对既往有肾脏疾病的患者具有更高的肾毒性潜力。尿量和血清肌酐的恒定值表明，在本研究中，当给予充分水化的患者时，两种造影剂均无临床相关的肾毒性。这强调了充分水化在预防肾毒性作用中的重要性，尤其是在有危险因素的患者中。
