Effect of radiographic contrast media on renal perfusion – First results

Lamby, Philipp; Jung, F.; Falter, Johannes; Mrowietz, C.; Graf, Simone; Schellenberg, Lotte; Silva, N. Platz Batista da; Prantl, Lukas; Franke, R.P.; Jung, Ernst Michael

doi:10.3233/ch-168110

Cited by 10 publications

(4 citation statements)

References 19 publications

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“…An animal study in young and healthy pigs showed that repeated administration of CM can be associated with a transient increase in the "Renal Resistance Index" (RRI) [15]. This had been demonstrated before also in a clinical study [16].…”

Section: Introductionmentioning

confidence: 71%

“…The pathophysiological findings from the previous in vivo study demonstrated in young healthy pigs that the administration of CM can lead to an increase in the RRI [ 15 ] and to a transient disorder of the renal microcirculation as well [ 17 ]. This was dependent on the type of CM administered and was clearly more pronounced after administration of Iopromide vs. Iodixanol.…”

Section: Discussionmentioning

confidence: 99%

“…This was in line with another animal study in which could be shown that iodinated CM deteriorate the oxygen tension in the renal cortico-medullary region of pigs [ 18 ]. The studies [ 15 , 17 , 18 ] have been conducted within the same animal cohort of the presented study according to the 3R principle (refinement, reduction, and replacement).…”

Section: Introductionmentioning

confidence: 99%

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Histological and SEM Assessment of Blood Stasis in Kidney Blood Vessels after Repeated Intra-Arterial Application of Radiographic Contrast Media

Lamby

Minkow

Handt³

et al. 2020

Life

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Background: After application of iodinated contrast media (CM), a pronounced deterioration of the microcirculation in skin and myocardium was reported. Clinically, the repeated application of CM, especially, led to an increase of the renal resistance index (RRI). With respect to the transiency of the RRI increase, it is reasonable to assume that the deterioration of blood flow could be due to transient blood stasis caused by reversible morphologic cell alterations due to osmotic discrepancies between CM and human blood. Therefore, the hypothesis was investigated whether CM are able to induce in vivo such blood stasis and cell deformations in the renal vasculature of well-hydrated pigs. Methods: The in vivo study was performed as a prospective randomized examination to compare the effects of two different CM in 16 pigs (German Landrace). Pigs were randomized to receive either Iodixanol (n = 8), or Iopromide (n = 8). Each animal received 10 injections separated by 5-min intervals via the suprarenal aorta at a rate of 10 mL/s according to the usual procedure during a cardiac catheter examination. Finally, the kidneys were explanted and processed for histology (H & E staining and fibrin staining according to Weigert) as well as for scanning electron microscopy (SEM) with regards to morphologic correlates explaining the changes in the microcirculation. Results: In each of the predefined four categories of vascular diameters, blood stasis were found, but clearly more often after application of Iopromide than after application of Iodixanol (p < 0.001). In addition, Iopromide induced more blood stasis in all of the examined kidney regions compared to Iodixanol (p = 0.0001). There were no obstructive events in the middle cortex following the application of Iodixanol. Except for the region around a puncture channel of a placed-in catheter probe, no fibrin was detected in Weigert’s fibrin-stained samples, neither around the histologically assessed thrombi nor in vessels with blood stasis. Complementary SEM analyses revealed in a few cases only a slight generation of fibrin and thrombi and deformations, such as echinocyte and “box-like” deformations. Conclusions: According to previous in vitro studies, pathological erythrocyte deformations, such as echinocyte and box-like formation of erythrocytes, were observed also in vivo. In addition, blood stasis and/or thrombi could be detected in histological samples from explanted kidneys from young pigs after repeated in vivo administration of CM. In only a few cases, mural platelet aggregates within minimal fibrin meshes occurred only after the application of Iopromide.

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Section: Introductionmentioning

confidence: 71%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Histological and SEM Assessment of Blood Stasis in Kidney Blood Vessels after Repeated Intra-Arterial Application of Radiographic Contrast Media

Lamby

Minkow

Handt³

et al. 2020

Life

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“…However, they have possible side effects and are time consuming and unsuited for bedside application. Angiography requires puncturing the fistula or the afferent artery, making it invasive (Lamby et al 2016(Lamby et al , 2017. Individuals are exposed to nephrotoxic contrast agents and radiation, possibly causing impaired renal perfusion, reduced kidney function, hyperthyroidism and allergic reactions.…”

Section: Introductionmentioning

confidence: 99%

Sonographic 3-D Power Doppler Imaging Enhances Rapid Assessment of Morphologic and Pathologic Arteriovenous Fistula Variations

Putz

Pfister

Bergler

et al. 2021

Ultrasound in Medicine & Biology

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Early detection of pathologic variations in an arteriovenous fistula (AVF) is essential for preventing fistula dysfunction in individuals undergoing hemodialysis. This study aimed to evaluate the clinical applicability of 3-D tomographic ultrasound (tUS) for rapid and simple visualization of AVF morphology and pathology. We assessed 53 AVFs in 50 consecutive patients using 3-D tUS including secondary, blinded reading. For all examinations, a high-end ultrasound (US) device was used with linear probe, attached to a tUS system to allow freehand 3-D scanning. Participants were examined by 2-D US and 3-D tUS with different raw data (B-mode, power Doppler, B-flow). Additional angiography was available for 15 participants with scheduled interventions. In all participants, 3-D tUS allowed a 3-D representation of AVFs in angiographic-like images with good image quality. The 2-D US assessment took 7.9 § 4.0 min. A 3-D power Doppler scan required, on average, 1.4 § 0.6 min. Diagnostic accuracy of blinded reading for pathologies was high (86.8% for aneurysms and 79.2% for stenoses). BlandÀAltman plots showed an excellent correlation of 3-D tUS with 2-D US and angiography. 3-D tUS is an easily and rapidly applicable method for visualizing morphologic and pathologic AVF variations. Color-coded 3-D reconstruction of power Doppler data simplifies detection of perfused aneurysms and stenoses.

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A Randomized Trial of Recombinant Human C1-Esterase-Inhibitor in the Prevention of Contrast-Induced Kidney Injury

Panagiotou

Trendelenburg

Heijnen

et al. 2020

JACC: Cardiovascular Interventions

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Effect of radiographic contrast media on renal perfusion – First results

Abstract: While iso-osmolar CM induced an increase of PSV and EDV together with a decrease of RRI, low-osmolar CM could not show this effect or rather led to the opposite.

Cited by 10 publications

References 19 publications

Histological and SEM Assessment of Blood Stasis in Kidney Blood Vessels after Repeated Intra-Arterial Application of Radiographic Contrast Media

Histological and SEM Assessment of Blood Stasis in Kidney Blood Vessels after Repeated Intra-Arterial Application of Radiographic Contrast Media

Sonographic 3-D Power Doppler Imaging Enhances Rapid Assessment of Morphologic and Pathologic Arteriovenous Fistula Variations

A Randomized Trial of Recombinant Human C1-Esterase-Inhibitor in the Prevention of Contrast-Induced Kidney Injury

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