Ultrassonografia modo B e Doppler na avaliação renal de cães submetidos à tomografia computadorizada após administração intravenosa de diferentes meios de contraste iodado

Abstract

Contrast-induced nephropathy (CIN) is an acute disease, secondary to intravascular administration of iodinated contrast media (ICM). The most important mechanisms of this nephropathy are intrarenal prolonged vasoconstriction, medular hypoxia, and ischemia associated with renal tubular damage due to contrast cytotoxicity. Owing to the limited information available in veterinary literature regarding these mechanisms this study aims to compare the renal effects of intravenous administration of two nonionic ICM of different osmolarities in groups of dogs with risk factors for CIN development, by using a B-mode, color, power-and pulsed-wave Doppler ultrasonography, and other laboratory tests, in order to indirectly estimate the nephrotoxic potential of each contrast. The following two groups were established according to the nonionic ICM used: the GIH group [11 dogs administered iohexol (low osmolarity)] and the GID group [seven dogs administered iodixanol (iso-osmolarity)]. Both the groups were administered the same dose (600mgI/kg/IV). The following renal aspects were evaluated before administration of ICM (baseline) and after 1h30min, 24h, and 48h: renal morphometry (length and volume), renal morphology, cortical echogenicity, renal perfusion, and intrarenal vascular resistance (resistive and pulsatility indices); in addition, urinalysis was performed, and urinary gamma-glutamyl transferase:creatinine ratio (GGT:C), urinary protein:creatinine ratio (UPC), and serum creatinine were also measured. Both groups showed similar characteristics with respect to the length, volume, UPC ratio, urinalysis, and serum creatinine levels. No similarity was observed with respect to the pulsatility index (PI) in both the groups and there were no significant differences between baseline and 1h30min, 24h and 48h time points. With respect to the IR and urinary GGT:C, both groups showed no similarity, and significant increases were 1 Recebido em 13 de maio de 2016.Aceito para publicação em 6 de dezembro de 2016. Parte da tese de doutorado do primeiro autor.

Ultrasonographic assessment of renal perfusion in bitches with mammary carcinoma treated with long-term carprofen

“…Contrast-enhanced ultrasound can reportedly show changes in renal flow six weeks before creatinine values are significantly increased for the species, allowing an early diagnosis of renal diseases and their treatment 9 . The importance and reliability of Doppler flowmetry in identifying early changes in renal flow, anticipating irreversible structural damage to the kidneys, has also been described 6 , 10 .…”

Ultrasonographic Assessment of Renal Perfusion in Bitches With Mammary Carcinoma Treated With Long-Term Carprofen

“…Dong et al (2013) described that CEUS can show changes in renal ow six weeks before creatinine values are signi cantly increased for the species, allowing an early diagnosis of renal diseases and their treatment. Similarly,Melo et al (2006) andMartín et al (2017) described the importance and reliability of Doppler owmetry in identifying early changes in renal ow, anticipating irreversible structural damage to the kidneys. As such, the authors consider that there was no change in renal perfusion resulting from the treatment, and that the development of proteinuria and CKD were due to factors inherent to the patients and not the treatment.DaSilva et al (2014) reported that hematologic changes are common in patients with mammary neoplasia, often with presence of anaemia.…”