Objectives
To assess if streptozotocin (STZ) induced diabetic rats develop iodinated contrast induced acute kidney injury (CIAKI). The intra-renal R2* (= 1/ T2*) was evaluated continuously before-during-after contrast administration. Renal injury was confirmed by urinary neutrophil gelatinase-associated lipocalin (uNGAL) measurements.
Materials and Methods
Six Sprague-Dawley rats were administered STZ to induce diabetes (Group 1). R2* was measured before, during, and after administration of iodixanol. R2* readings were sampled from four renal regions: inner medulla, inner stripe of outer medulla (ISOM), outer stripe of outer medulla, and cortex. Peak R2* and initial up-slope of R2* increase following iodinated contrast were calculated. Data from 12 non-diabetic rats pre-treated with nitric oxide synthase and prostaglandin inhibitors to induce susceptibility to CIAKI (pre-treatment model) from a previous study were re-analyzed for peak R2* and initial up-slope of R2* increase following contrast. Six of these animals received saline (Group 2) and the other six received furosemide (Group 3) prior to idoxianol.
Results
Peak R2* and initial up-slope of R2* increase were used as BOLD response parameters. R2* in ISOM were comparable in all three groups prior to administration of furosemide. Except for the furosemide group, ISOM showed a rapid increase in R2* immediately following contrast administration. Unlike the L-NAME & indomethacin treated groups, the diabetic group showed a quick reversal of R2* towards baseline measurements after contrast administration. Urinary NGAL indicated significant increase in diabetic rats 4 hours following contrast administration. The observed trends with peak R2* and initial up-slope of R2* increase in renal ISOM were in agreement with those of uNGAL.
Conclusion
The STZ induced diabetic rat may be suitable for studying the effects of iodinated contrast on renal oxygenation status and may mimic human condition closer than the pre-treatment model described before. The peak R2* value and initial up-slope of R2* in ISOM appear to be effective MRI markers to predict renal injury following administration of an iodinated contrast agent.