Anto H R, Chou S Y, Porush J G, Shapiro W B
Arch Intern Med. 1981 Nov;141(12):1652-6.
In a previous prospective study, we reported that infusion intravenous pyelography (IVP) in 40 patients with chronic renal insufficiency resulted in acute renal failure (ARF) in 28 patients (70%). In an attempt to prevent this complication, we have evaluated the conditions of another group of 37 patients with chronic renal insufficiency treated in a similar manner except that each patient received 250 mL of 20% mannitol 60 minutes after infusion of the IVP dye (diatrizoate sodium, 300 mL of a 30% solution). These patients were similar to those in the previous study with regard to age, sex, renal function, and incidence of diabetes. Only eight (22%) of the 37 patients had ARF develop after infusion IVP in this study. This incidence was significantly lower compared with 70% in the previous study. We conclude that administration of hypertonic mannitol 60 minutes after administration of the radiographic contrast material is highly effective in preventing ARF after infusion IVP in patients with chronic renal insufficiency.
在之前的一项前瞻性研究中，我们报告称，40例慢性肾功能不全患者进行静脉肾盂造影（IVP）后，28例（70%）发生了急性肾衰竭（ARF）。为了预防这一并发症，我们评估了另一组37例慢性肾功能不全患者的情况，这些患者接受了类似的治疗，只是在注入IVP染料（泛影酸钠，30%溶液300 mL）60分钟后，每位患者都接受了250 mL的20%甘露醇。这些患者在年龄、性别、肾功能和糖尿病发病率方面与之前研究中的患者相似。在本研究中，37例患者中只有8例（22%）在注入IVP后发生了ARF。与之前研究中的70%相比，这一发生率显著更低。我们得出结论，对于慢性肾功能不全患者，在给予放射造影剂60分钟后给予高渗甘露醇，对于预防注入IVP后的ARF非常有效。
