Pranoto Indrianto W, Djojodimedjo Tarmono, Soebadi Mohammad A, Rahaju Anny S
Department of Urology, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia.
Department of Urology, Dr. Soetomo General Academic Hospital, Surabaya, Indonesia.
Narra J. 2024 Dec;4(3):e1227. doi: 10.52225/narra.v4i3.1227. Epub 2024 Nov 21.
Contrast-induced acute kidney injury is a common complication marked by reduced kidney function within 48 hours of contrast administration. The aim of this study was to evaluate renal function, anatomy, and molecular changes at 24 hours, 48 hours, and 72 hours post-iodinated contrast media (ICM) administration. This true-experimental study used a post-test-only control group design. Rats underwent unilateral nephrectomy, followed by intravenous injection of ICM using iopromide 370 mg iodine/mL per rat at a dose of 231 mg iodine, and were then divided into four groups: control (C), rats terminated at 24 hours after iopromide administration (E24), rats terminated at 48 hours after iopromide administration (E48), and rats terminated at 72 hours (E72) after iopromide administration, with eight rats per group. Renal function (BUN and SCr levels) remained unchanged after 24, 48, and 72 hours of iopromide administration. Iopromide increased renal tubular damage, as shown by higher histopathological scores for loss of brush border and tubular necrosis, except for proteinaceous casts, where histopathological scores increase especially within the first 24 hours and decrease after 72 hours. Iopromide significantly altered iNOS expression in the glomerulus at 24 and 48 hours, and iNOS expression was decreased after 72 hours. iNOS expression in the intrarenal vascular and tubules was unaffected by iopromide administration. In conclusion, this study found no changes in renal function parameters, improvement in proteinaceous casts, and increased iNOS expression in the glomerulus, offering new insights into the effects of contrast on kidneys.
对比剂诱导的急性肾损伤是一种常见并发症,其特征为在使用对比剂后48小时内肾功能下降。本研究的目的是评估碘化对比剂(ICM)给药后24小时、48小时和72小时的肾功能、解剖结构和分子变化。这项真实实验研究采用了仅后测对照组设计。大鼠接受单侧肾切除术,然后以每只大鼠231毫克碘的剂量静脉注射370毫克碘/毫升的碘普罗胺ICM,随后分为四组:对照组(C)、碘普罗胺给药后24小时处死的大鼠(E24)、碘普罗胺给药后48小时处死的大鼠(E48)以及碘普罗胺给药后72小时处死的大鼠(E72),每组8只大鼠。碘普罗胺给药24小时、48小时和72小时后,肾功能(血尿素氮和血清肌酐水平)保持不变。碘普罗胺增加了肾小管损伤,表现为刷状缘丧失和肾小管坏死的组织病理学评分更高,但蛋白质管型除外,蛋白质管型的组织病理学评分在前24小时内尤其增加,72小时后下降。碘普罗胺在24小时和48小时时显著改变了肾小球中诱导型一氧化氮合酶(iNOS)的表达,72小时后iNOS表达下降。肾内血管和肾小管中的iNOS表达不受碘普罗胺给药的影响。总之,本研究发现肾功能参数无变化、蛋白质管型有所改善以及肾小球中iNOS表达增加,为对比剂对肾脏的影响提供了新的见解。