Renal Safety of Iodinated Contrast Media Depending on Their Osmolarity – Current Outlooks

Mruk, Bartosz

doi:10.12659/pjr.895406

Cited by 26 publications

(18 citation statements)

References 52 publications

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“…Chemical effects are mainly referred as contrast-induced nephropathy (CIN) and will be discussed later. Anaphylactic reaction is the most common situation in constitutional effect and may cause mild symptom such as nausea and vomiting, dizziness, rash and itch, or chest discomfort, shock in more severe situation, or even death [ 21 , 23 , 28 , 29 , 32 ]. Iodinated contrast media cause little allergic reactions, especially for low-osmolar contrast media (LOCM).…”

Section: The Adverse Drug Reaction (Adr) Of Iodinated Contrast Media mentioning

confidence: 99%

The molecular mechanism of contrast-induced nephropathy (CIN) and its link to in vitro studies on iodinated contrast media (CM)

et al. 2018

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Iodinated contrast media (iodinated CM) have increased ability to absorb x-rays and to visualize structures that normally are impossible to observe in a radiological examination. The use of iodinated CM may destory renal function, commonly known as contrast-induced nephropathy (CIN), which can result in acute renal failure (ARF). This review article mainly focuses on the following areas: (1) classifications of iodinated CM: ionic or non-ionic, high-osmolarity contrast media (HOCM), low-osmolarity contrast media (LOCM) and iso-osmolarity contrast media (IOCM); (2) an introduction to the physical and chemical properties of the non-ionic iodinated CM; (3) the management of anaphylactic reaction by iodinated CM; (4) a suggested single injection of adult doses and maximum dose for non-ionic iodinated CM; (5) the molecular mechanism of contrast-induced nephropathy (CIN); (6) In vitro studies on iodinated CM. Based on above information, this review article provide an insight for understanding the drug safety of iodinated CM.

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Section: The Adverse Drug Reaction (Adr) Of Iodinated Contrast Media mentioning

confidence: 99%

The molecular mechanism of contrast-induced nephropathy (CIN) and its link to in vitro studies on iodinated contrast media (CM)

et al. 2018

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“…It is reported to have a lower risk of nephropathy compared with other contrast agents [ 5 ]. Thus, adverse reactions caused by osmolality have been reduced; however, hypersensitivity and other specific reactions induced by contrast agents are increasing [ 6 ]. Although little is known as yet about the pathogenesis of contrast-induced nephropathy, hypoxia, renal ischemia, and cytotoxic effects on renal tubular cells have been reported to cause contrast-induced nephropathy [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

Anti-Apoptotic and Antioxidant Effects of 3-Epi-Iso-Seco-Tanapartholide Isolated from Artemisia argyi against Iodixanol-Induced Kidney Epithelial Cell Death

et al. 2020

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Iodixanol is a non-ionic iso-osmolar contrast agent, but it is a risk factor for kidney damage and increases morbidity and mortality. In this study, we investigated the effect of 9 sesquiterpenes isolated from mugwort (Artemisia argyi) in contrast agent-induced cytotoxicity in LLC-PK1 cells. Cells were exposed to nine sesquiterpene compounds for 2 h, followed by incubation with iodixanol for 3 h. Cell viability was assessed using the Ez-Cytox assay. The level of reactive oxygen species was measured using 2′,7′-dichlorodihydrofluorescein diacetate staining. Apoptotic cell death was detected using annexin V/PI staining. In addition, immunofluorescence staining and western blotting were performed using antibodies against proteins related to apoptosis, oxidative stress, and MAPK pathways. The most effective 3-epi-iso-seco-tanapartholide (compound 8) among the 9 sesquiterpene compounds protected LLC-PK1 cells from iodixanol-induced cytotoxicity, oxidative stress, and apoptotic cell death. Pretreatment with compound 8 reversed iodixanol-induced increases in the expression of JNK, ERK, p38, Bax, caspase-3, and caspase-9. It also reversed the iodixanol-induced decrease in Bcl-2 expression. Furthermore, pretreatment with compound 8 caused nuclear translocation of Nrf2 and upregulated HO-1 via the Nrf2 pathway in iodixanol-treated LLC-PK1 cells. Thus, we demonstrated here that compound 8 isolated from A. argyi has the potential to effectively prevent iodixanol-induced kidney epithelial cell death via the caspase-3/MAPK pathways and HO-1 via the Nrf2 pathway.

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“…1 CIN, which is mainly induced by iodinated contrast media (ICM), is an acute renal insufficiency occurred in patients with normal renal function, or a worsen of chronic renal insufficiency. 2 Although ICM is relatively safe, adverse events occurs from time to time. The typical clinical manifestation of CIN is non-oliguria acute renal damage, which generally occurs within 1 or 2 days after contrast application.…”

Section: Chinese Medical Sciences Journal June 2017mentioning

confidence: 99%

Can Fundus Fluorescein Angiography be Performed for Diabetic Patients on Oral Metformin?△

2017

Chinese Medical Sciences Journal

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Metformin is a kind of biguanide hypoglycemic agent that has been widely used in patients with diabetes mellitus. In clinical practice, whether metformin should be stopped before Fundus fluorescein angiography (FFA) remains largely unclear. Some endocrinologists suggest stop metformin before FFA. However, ophthalmologists do not always adopt this opinion in their practice. This situation may lead to disputes between physicians and patients. This article analyzed contrast-induced nephropathy(CIN) and the related contrast agent, as well as the adverse reactions of fluorescein angiography. It pointed out that the discrepancy may be caused by misunderstanding of contrast agents used in FFA. For angiography using iodine contrast agent, metformin must be stopped because of the increased possibility of CIN, while for FFA using fluorescein sodium, no CIN has been reported yet. Therefore, the authors believe FFA is safe for diabetic patients with oral metformin and it is unnecessary to stop metformin before the examination.

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Renal Safety of Iodinated Contrast Media Depending on Their Osmolarity – Current Outlooks

Cited by 26 publications

References 52 publications

The molecular mechanism of contrast-induced nephropathy (CIN) and its link to in vitro studies on iodinated contrast media (CM)

The molecular mechanism of contrast-induced nephropathy (CIN) and its link to in vitro studies on iodinated contrast media (CM)

Anti-Apoptotic and Antioxidant Effects of 3-Epi-Iso-Seco-Tanapartholide Isolated from Artemisia argyi against Iodixanol-Induced Kidney Epithelial Cell Death

Can Fundus Fluorescein Angiography be Performed for Diabetic Patients on Oral Metformin?△

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