Randomised Prospective Study on Renal Effects of Two Different Contrast Media in Humans: Protective Role of a Calcium Channel Blocker

Abstract

Contrast media affect renal hemodynamics. Hyperosmolality is regarded as the major factor responsible for renal hemodynamic changes. In this study, the role of osmolality was evaluated in 30 hospitalized patients without risk factors during intravenous pyelography. Contrast media with low and high osmolality were used. In addition, nifedipine was administered before infusion of high-osmolality contrast to evaluate the role of calcium ions in radiocontrast-induced changes of renal hemodynamics. Hyperosmolar contrast reduced renal plasma flow and glomerular filtration rate. Calcium channel blocker prevented changes of renal hemodynamics. Hyperosmolality appears the most likely factor affecting renal hemodynamics during hyperosmolar radiocontrast infusion. Calcium channel blocker may prevent renal changes due to hyperosmolar medium.

Early and Sustained Systemic and Renal Hemodynamic Effects of Intravenous Radiocontrast

“…We, like many investigators before [13,[19][20][21][22][23][24][25][26] , identified a decrease in renal blood flow and an increase in renal vascular resistance (decreased conductance) in the first 60 min after radiocontrast injection. In addition, like other investigators, we found a return of renal blood flow to baseline within 120 min of injection [22] . Thus, our findings are entirely consistent with several previous short-term observations.…”

Coronary Angiography and Contrast-Induced Nephropathy

“…Patients (n=20) who received sublingual nifedipine did not have a significant increase in serum creatinine, while those in the placebo group did (Rodicio et al, 1990). In another study, patients (n=30) who received nifedipine had an increase in renal plasma flow following administration of contrast, while patients in the placebo group had a decrease in renal flow (Russo et al, 1990). One other study showed that nitrendipine use cause a significant reduction in the GFR in the placebo group compared to little or no change in GFR in the nitrendipine group (Neumayer et al, 1989).…”

Contrast-Induced Nephropathy in Patients with Type 2 Diabetes Mellitus and Coronary Artery Disease: Update and Practical Clinical Applications

“…There are other medicines that may attenuate the risk of CIN. Calcium-channel blocking medications attenuate both the magnitude and duration of renal vasoconstriction after contrast medium administration (Russo et al, 1990). In patients with type 2 diabetes mellitus and hypertension and/or angina requiring calcium-channel blocking medications, these medications should be continued if contrast medium administration is planned.…”