Webb J A
Br J Radiol. 1984 May;57(677):387-93. doi: 10.1259/0007-1285-57-677-387.
The changes in glomerular filtration rate (GFR) after intravenous contrast medium have been investigated with three contrast media of differing osmolality (monomer, dimer and non-ionic agent) in antidiuretic dogs with three different basal solute excretion rates. A transient increase in GFR after contrast medium was attributed to the wash-out of medullary creatinine at the onset of diuresis. The subsequent fall in GFR was greatest with the contrast media of higher osmolality and in those dogs without an underlying solute diuresis. With the monomer, the decrease in GFR produced a significant decrease in the amount of contrast medium excreted in the first few minutes after contrast injection. It is suggested that an important factor in the decrease in GFR is the rise in pressure in the renal tubules at the start of a diuresis, before they have had time to dilate. An underlying solute diuresis is considered to protect against the fall in GFR because tubular dilatation has already occurred in response to the basal solute load. The decrease in blood pressure during and after contrast medium injection did not correlate with the fall in GFR.
在具有三种不同基础溶质排泄率的抗利尿犬中，使用三种不同渗透压的造影剂（单体、二聚体和非离子型制剂）研究了静脉注射造影剂后肾小球滤过率（GFR）的变化。造影剂注射后GFR的短暂升高归因于利尿开始时髓质肌酐的清除。随后，GFR的下降在渗透压较高的造影剂以及那些没有潜在溶质利尿的犬中最为明显。使用单体时，GFR的降低导致造影剂注射后最初几分钟内排泄的造影剂数量显著减少。有人提出，GFR降低的一个重要因素是在肾小管有时间扩张之前，利尿开始时肾小管内压力的升高。潜在的溶质利尿被认为可以防止GFR下降，因为肾小管已经因基础溶质负荷而发生了扩张。造影剂注射期间和之后的血压下降与GFR的下降无关。
