Golman K, Holtås S
Invest Radiol. 1980 Nov-Dec;15(6 Suppl):S61-5. doi: 10.1097/00004424-198011001-00015.
All angiographic and urographic procedures expose the kidney to high contrast medium concentrations. The introduction of the triiodinated ionic contrast media has lowered the risk of contrast medium-induced renal damage. An increase in dose and use of "bolus urography" have, however, led to an increase in frequency of reports on renal damage following intravenous pyelography and angiography. The low general toxicity of the new nonionic contrast media should also include a lower toxicity towards the kidneys. The media are, however, concentrated in the kidney to twice the concentration of the ionic media, and this might blur the expected reduction in kidney toxicity. The authors examined this problem by studying enzymuria in rabbits and albuminuria in rats after injection of different ionic and nonionic contrast media. In the rabbit, the model should imitate a urography and in the rat, a nephroangiography. All contrast media resulted in enzymuria and albuminuria, but to different degrees. The time for maximum enzymuria differed from the time of maximum albuminuria. The proteinuria does not appear to be related to the osmotic pressure of the injected contrast medium. The clinical significance of these findings is discussed.
所有血管造影和尿路造影操作都会使肾脏暴露于高浓度造影剂中。三碘离子型造影剂的引入降低了造影剂诱发肾损伤的风险。然而，剂量的增加和“团注尿路造影”的使用导致静脉肾盂造影和血管造影后肾损伤报告的频率有所增加。新型非离子型造影剂较低的总体毒性也应包括对肾脏较低的毒性。然而，这些造影剂在肾脏中的浓度是离子型造影剂的两倍，这可能会模糊预期的肾脏毒性降低。作者通过研究注射不同离子型和非离子型造影剂后兔子的酶尿症和大鼠的蛋白尿来研究这个问题。在兔子身上，该模型应模拟尿路造影，在大鼠身上，应模拟肾血管造影。所有造影剂都会导致酶尿症和蛋白尿，但程度不同。最大酶尿症出现的时间与最大蛋白尿出现的时间不同。蛋白尿似乎与注射造影剂的渗透压无关。本文讨论了这些发现的临床意义。
