Infusion of radiocontrast agents induces exaggerated release of urinary endothelin in patients with impaired renal function

Abstract

In the present study, uET/Cr increased after the administration of CM only in the patients with renal impairment. This difference in endothelin reaction may be a causal one, in that patients with renal insufficiency readily develop RCN. The infusion of half-normal saline starting before CM infusion causes no side effects and is safe for the prevention of CM-induced acute renal failure. The aim of the study was to examine the role of endothelin in radiocontrast-induced nephropathy (RCN) in patients with chronic renal failure.

The contrast medium volume to estimated glomerular filtration rate ratio as a predictor of contrast-induced nephropathy after primary percutaneous coronary intervention

“…The outer medulla is particularly susceptible to ischemic injury because of its high metabolic activity and low prevailing oxygen tension. Fujisaki et al [18] noted that urinary endothelin levels were markedly elevated in patients with chronic renal failure who were undergoing cardiac catheterization. Furthermore, contrast medium has been shown to have a direct toxic effect on renal epithelial cells [19].…”

Contrast-induced nephropathy

“…Moreover, endothelin transcription is enhanced and endothelin is released from endothelial cells in response to CM [16]. Finally, in patients with impaired renal function, the increase in endothelin after giving CM is exaggerated [17]. The effects of endothelin on the vasculature are very dependent upon the receptor subtype.…”

Does Renin-Angiotensin Aldosterone System Blockade Exacerbate Contrast-Induced Nephropathy in Patients with Chronic Kidney Disease? A Prospective 50-month Mayo Clinic Study

“…[26] We submit that new-onset dipstick proteinuria represents an early sign of acute tubular injury from the contrast medium and may serve as a surrogate marker for the 71 development of severe CIN. [5,18,26] We propose that in less affluent settings, where daily or more frequent serum creatinine estimations may not be possibly carried out due to cost limitations, new-onset dipstick proteinuria (1+ to 3+) or increasing UACR indices (mg/g)-both cheaper alternative tests-may be useful pointers to the development of impending severe CIN.…”