The Osmolality of Nonionic, Iodinated Contrast Agents as an Important Factor for Renal Safety

Lenhard, Diana C.; Pietsch, Hubertus; Sieber, Martin; Ernst, R.; Lengsfeld, Philipp; Ellinghaus, Peter; Jošt, Gregor

doi:10.1097/rli.0b013e318258502b

Cited by 38 publications

(30 citation statements)

References 26 publications

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“…Thus, urine viscosity was found higher in rats and dogs following IOCM than LOCM [19,20,26,42]; this was also corroborated in a small series of well hydrated patients [20]. Studies in rats and minipigs showed that the higher urine viscosity leads to a longer renal retention of IOCM than LOCM [32,35,41,43], which is accompanied by higher levels of injury markers [32,41]. Also, intrarenal oxygenation was much more compromised following IOCM than LOCM as monitored by invasive probes and blood oxygenation leveldependent (BOLD) magnetic resonance [20,32,33,35].…”

Section: Issn: 2380-0585mentioning

confidence: 68%

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Comparison of the Effects of Iodixanol and Iopamidol on Urine Flow, Urine Viscosity, and Glomerular Filtration in Rats

2015

J Urol Nephrol

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Dehydration is a major risk for contrast media (CM) induced acute kidney injury, yet prospective studies in human patients without ample hydration are not feasible. The freely drinking rat can serve as a model for hydropenic humans.We compared the effects of two CM, iso-osmolar iodixanol and lowosmolar iopamidol, on urine flow, urine viscosity and glomerular filtration rate (GFR) in non-hydrated rats, and studied the impact of hydration by saline. In four groups of rats, either iodixanol 320 mg iodine/mL or iopamidol 370 mg iodine/mL was injected as 1.5 mL bolus into the thoracic aorta. Two groups had access to drinking water only and two groups received additional saline infusion (4 mL/hour per kg) starting 60 min before CM injection. Urine was collected (10 min sampling periods), urine viscosity measured, and GFR determined by creatinine clearance. In nonprehydrated rats, iodixanol led to a massive increase in urine viscosity and a transient 50% drop in GFR. Iopamidol had a much stronger diuretic effect than iodixanol, urine viscosity increased much less and GFR was unaffected. Saline infusion blunted the viscosity rise and transient decline in GFR caused by iodixanol. It is concluded that the choice of CM and ample hydration are important elements in the prevention of CM induced kidney injury. Low-osmolar iopamidol has a better renal safety profile than iso-osmolar iodixanol, at least in non-hydrated subjects. Hydration by saline counteracts the renal tubular concentration of CM thereby alleviating the increase in urine viscosity and the decline in GFR.

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Section: Issn: 2380-0585mentioning

confidence: 68%

“…Here, the difference in CM osmolalities plays a major role (290 versus 796 mosmol/kg H 2 O) [29,32,41]. Non-reabsorbable CM diminish the osmotic gradient that drives tubular water resorption, thereby inducing osmodiuresis.…”

Section: Issn: 2380-0585mentioning

confidence: 99%

Comparison of the Effects of Iodixanol and Iopamidol on Urine Flow, Urine Viscosity, and Glomerular Filtration in Rats

2015

J Urol Nephrol

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“…However, a key difference between IOCM (iodixanol) and LOCM (iohexol) is the viscosity, with iodixanol being much more viscous than LOCM. This viscosity has been suggested to be a potential contributing factor in AKI seen in patients who receive iodixanol [27] and could negate any benefit that might derive from being iso-osmolar.…”

Section: Discussionmentioning

confidence: 94%

Contrast-induced nephropathy in outpatients with preexisting renal impairment: a comparison between intravenous iohexol and iodixanol

et al. 2016

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“…Its high osmolarity as well as a high viscosity can lead to poor patient tolerance. Dimeric iodine-based CA show an increase in retention in the kidneys [35] and can cause renal injury [36]. When comparing low-osmolarity CA with ones isotonic to blood plasma, a metastudy found a just-significant difference in contrast-induced nephropathy incidence [37].…”

Section: Contrast In X-raymentioning

confidence: 99%

Gold Nanoparticles as X-Ray, CT, and Multimodal Imaging Contrast Agents: Formulation, Targeting, and Methodology

Mahan

Doiron

2018

Journal of Nanomaterials

116

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Computed tomography (CT) is among the most popular medical imaging modalities due to its high resolution images, fast scan time, low cost, and compatibility with all patients. CT scans of soft tissues require the localization of imaging contrast agents (CA) to create contrast, revealing anatomic information. Gold nanoparticles (AuNP) have attracted interest recently for their use as CT CA due to their high X-ray attenuation, simple surface chemistry, and biocompatibility. Targeting molecules may be attached to the particles to allow for the targeting of specific cell types and disease states. AuNP can also be readily designed to incorporate other imaging contrast agents such as rare earth metals and dyes. This review summarizes the current state-of-the-art knowledge in the field of AuNP used as X-ray and multimodal contrast agents. Primary research is analyzed through the lens of structure-propertyfunction to best explain the design of a particle for a given application. Design specification of particles includes size, shape, surface functionalization, composition, circulation time, and component synergy. Key considerations include delivery of a CA payload to the site of interest, nontoxicity of particle components, and contrast enhancement compared to the surrounding tissue. Examples from literature are included to illustrate the strategies used to address design considerations.

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The Osmolality of Nonionic, Iodinated Contrast Agents as an Important Factor for Renal Safety

Cited by 38 publications

References 26 publications

Comparison of the Effects of Iodixanol and Iopamidol on Urine Flow, Urine Viscosity, and Glomerular Filtration in Rats

Comparison of the Effects of Iodixanol and Iopamidol on Urine Flow, Urine Viscosity, and Glomerular Filtration in Rats

Contrast-induced nephropathy in outpatients with preexisting renal impairment: a comparison between intravenous iohexol and iodixanol

Gold Nanoparticles as X-Ray, CT, and Multimodal Imaging Contrast Agents: Formulation, Targeting, and Methodology

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