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

Kiichiro Fujisaki, Michiaki Kubo, Katsutoshi Masuda, Masanori Tokumoto, Makoto Hirakawa, Hirofumi Ikeda, Rei Matsui, Dai Matsuo, Kyoichi Fukuda, Hidetoshi Kanai, Hideki Hirakata, Mitsuo Iida

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Abstract

Background. The aim of the study was to examine the role of endothelin in radiocontrast-induced nephropathy (RCN) in patients with chronic renal failure. Methods. We measured plasma endothelin-1.(ET) and the urinary excretion of endothelin-like immunoreactivity before and after infusion of radio contrast medium (CM) in patients with normal renal function (group N; n = 6; mean serum creatinine concentration, 0.8 ± 0.1 (SEM) mg/dl), and in another group, with renal dysfunction (group R; n = 6; 2.7 ± 0.5 mg/dl). Half-normal saline (0.45% NaCl solution) was continuously infused in all patients for 25 h, at a rate of 100 ml/h; starting from 5 h before the infusion of CM. Results. Plasma ET in group R (5.2 ± 1.4 pg/ml) was significantly higher than in group N (0.9 ± 0.3; P < 0.01). Urinary endothelin excretion corrected by creatinine concentration (uET/Cr) in group R (7.9 ± 2.4 mg/g Cr) was significantly higher than in group N (1.5 ± 0. 4 mg/g Cr; P < 0.05). Urinary excretion levels of N-acetyl-β -D-glucosaminidase (NAG) and β2-microglobulin (β2M) were also significantly higher in group R (0.8 ± 0.2 mU/g Cr and 670 ± 400 mg/g Cr, respectively) than in group N (0.3 ± 0.1 and 7.5 ± 2.2, respectively). After CM infusion, uET/Cr in group R significantly increased, to 10.7 ± 2.6 mg/g Cr on the next day and returned to baseline level on the third day. NAG and β2M showed a similar pattern, but a significant change in NAG was observed on the second day in group R. In group N, uET/Cr, NAG, and β2M did not change after CM infusion. Plasma ET remained unchanged throughout the observation period of 4 days in both groups. No patient developed pulmonary edema or a significant rise in serum creatinine (more than 0.5 mg/dl), caused by infusion of the amount of half-normal saline used. Conclusions. 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.

Original languageEnglish
Pages (from-to)279-283
Number of pages5
JournalClinical and Experimental Nephrology
Volume7
Issue number4
DOIs
Publication statusPublished - 01-12-2003

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Endothelins
Contrast Media
Hexosaminidases
Kidney
Creatinine
Endothelin-1
Pulmonary Edema
Serum
Radio
Acute Kidney Injury
Chronic Kidney Failure
Renal Insufficiency
Observation

All Science Journal Classification (ASJC) codes

  • Physiology
  • Nephrology
  • Physiology (medical)

Cite this

Fujisaki, Kiichiro ; Kubo, Michiaki ; Masuda, Katsutoshi ; Tokumoto, Masanori ; Hirakawa, Makoto ; Ikeda, Hirofumi ; Matsui, Rei ; Matsuo, Dai ; Fukuda, Kyoichi ; Kanai, Hidetoshi ; Hirakata, Hideki ; Iida, Mitsuo. / Infusion of radiocontrast agents induces exaggerated release of urinary endothelin in patients with impaired renal function. In: Clinical and Experimental Nephrology. 2003 ; Vol. 7, No. 4. pp. 279-283.
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title = "Infusion of radiocontrast agents induces exaggerated release of urinary endothelin in patients with impaired renal function",
abstract = "Background. The aim of the study was to examine the role of endothelin in radiocontrast-induced nephropathy (RCN) in patients with chronic renal failure. Methods. We measured plasma endothelin-1.(ET) and the urinary excretion of endothelin-like immunoreactivity before and after infusion of radio contrast medium (CM) in patients with normal renal function (group N; n = 6; mean serum creatinine concentration, 0.8 ± 0.1 (SEM) mg/dl), and in another group, with renal dysfunction (group R; n = 6; 2.7 ± 0.5 mg/dl). Half-normal saline (0.45{\%} NaCl solution) was continuously infused in all patients for 25 h, at a rate of 100 ml/h; starting from 5 h before the infusion of CM. Results. Plasma ET in group R (5.2 ± 1.4 pg/ml) was significantly higher than in group N (0.9 ± 0.3; P < 0.01). Urinary endothelin excretion corrected by creatinine concentration (uET/Cr) in group R (7.9 ± 2.4 mg/g Cr) was significantly higher than in group N (1.5 ± 0. 4 mg/g Cr; P < 0.05). Urinary excretion levels of N-acetyl-β -D-glucosaminidase (NAG) and β2-microglobulin (β2M) were also significantly higher in group R (0.8 ± 0.2 mU/g Cr and 670 ± 400 mg/g Cr, respectively) than in group N (0.3 ± 0.1 and 7.5 ± 2.2, respectively). After CM infusion, uET/Cr in group R significantly increased, to 10.7 ± 2.6 mg/g Cr on the next day and returned to baseline level on the third day. NAG and β2M showed a similar pattern, but a significant change in NAG was observed on the second day in group R. In group N, uET/Cr, NAG, and β2M did not change after CM infusion. Plasma ET remained unchanged throughout the observation period of 4 days in both groups. No patient developed pulmonary edema or a significant rise in serum creatinine (more than 0.5 mg/dl), caused by infusion of the amount of half-normal saline used. Conclusions. 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.",
author = "Kiichiro Fujisaki and Michiaki Kubo and Katsutoshi Masuda and Masanori Tokumoto and Makoto Hirakawa and Hirofumi Ikeda and Rei Matsui and Dai Matsuo and Kyoichi Fukuda and Hidetoshi Kanai and Hideki Hirakata and Mitsuo Iida",
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Fujisaki, K, Kubo, M, Masuda, K, Tokumoto, M, Hirakawa, M, Ikeda, H, Matsui, R, Matsuo, D, Fukuda, K, Kanai, H, Hirakata, H & Iida, M 2003, 'Infusion of radiocontrast agents induces exaggerated release of urinary endothelin in patients with impaired renal function', Clinical and Experimental Nephrology, vol. 7, no. 4, pp. 279-283. https://doi.org/10.1007/s10157-003-0246-y

Infusion of radiocontrast agents induces exaggerated release of urinary endothelin in patients with impaired renal function. / Fujisaki, Kiichiro; Kubo, Michiaki; Masuda, Katsutoshi; Tokumoto, Masanori; Hirakawa, Makoto; Ikeda, Hirofumi; Matsui, Rei; Matsuo, Dai; Fukuda, Kyoichi; Kanai, Hidetoshi; Hirakata, Hideki; Iida, Mitsuo.

In: Clinical and Experimental Nephrology, Vol. 7, No. 4, 01.12.2003, p. 279-283.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Infusion of radiocontrast agents induces exaggerated release of urinary endothelin in patients with impaired renal function

AU - Fujisaki, Kiichiro

AU - Kubo, Michiaki

AU - Masuda, Katsutoshi

AU - Tokumoto, Masanori

AU - Hirakawa, Makoto

AU - Ikeda, Hirofumi

AU - Matsui, Rei

AU - Matsuo, Dai

AU - Fukuda, Kyoichi

AU - Kanai, Hidetoshi

AU - Hirakata, Hideki

AU - Iida, Mitsuo

PY - 2003/12/1

Y1 - 2003/12/1

N2 - Background. The aim of the study was to examine the role of endothelin in radiocontrast-induced nephropathy (RCN) in patients with chronic renal failure. Methods. We measured plasma endothelin-1.(ET) and the urinary excretion of endothelin-like immunoreactivity before and after infusion of radio contrast medium (CM) in patients with normal renal function (group N; n = 6; mean serum creatinine concentration, 0.8 ± 0.1 (SEM) mg/dl), and in another group, with renal dysfunction (group R; n = 6; 2.7 ± 0.5 mg/dl). Half-normal saline (0.45% NaCl solution) was continuously infused in all patients for 25 h, at a rate of 100 ml/h; starting from 5 h before the infusion of CM. Results. Plasma ET in group R (5.2 ± 1.4 pg/ml) was significantly higher than in group N (0.9 ± 0.3; P < 0.01). Urinary endothelin excretion corrected by creatinine concentration (uET/Cr) in group R (7.9 ± 2.4 mg/g Cr) was significantly higher than in group N (1.5 ± 0. 4 mg/g Cr; P < 0.05). Urinary excretion levels of N-acetyl-β -D-glucosaminidase (NAG) and β2-microglobulin (β2M) were also significantly higher in group R (0.8 ± 0.2 mU/g Cr and 670 ± 400 mg/g Cr, respectively) than in group N (0.3 ± 0.1 and 7.5 ± 2.2, respectively). After CM infusion, uET/Cr in group R significantly increased, to 10.7 ± 2.6 mg/g Cr on the next day and returned to baseline level on the third day. NAG and β2M showed a similar pattern, but a significant change in NAG was observed on the second day in group R. In group N, uET/Cr, NAG, and β2M did not change after CM infusion. Plasma ET remained unchanged throughout the observation period of 4 days in both groups. No patient developed pulmonary edema or a significant rise in serum creatinine (more than 0.5 mg/dl), caused by infusion of the amount of half-normal saline used. Conclusions. 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.

AB - Background. The aim of the study was to examine the role of endothelin in radiocontrast-induced nephropathy (RCN) in patients with chronic renal failure. Methods. We measured plasma endothelin-1.(ET) and the urinary excretion of endothelin-like immunoreactivity before and after infusion of radio contrast medium (CM) in patients with normal renal function (group N; n = 6; mean serum creatinine concentration, 0.8 ± 0.1 (SEM) mg/dl), and in another group, with renal dysfunction (group R; n = 6; 2.7 ± 0.5 mg/dl). Half-normal saline (0.45% NaCl solution) was continuously infused in all patients for 25 h, at a rate of 100 ml/h; starting from 5 h before the infusion of CM. Results. Plasma ET in group R (5.2 ± 1.4 pg/ml) was significantly higher than in group N (0.9 ± 0.3; P < 0.01). Urinary endothelin excretion corrected by creatinine concentration (uET/Cr) in group R (7.9 ± 2.4 mg/g Cr) was significantly higher than in group N (1.5 ± 0. 4 mg/g Cr; P < 0.05). Urinary excretion levels of N-acetyl-β -D-glucosaminidase (NAG) and β2-microglobulin (β2M) were also significantly higher in group R (0.8 ± 0.2 mU/g Cr and 670 ± 400 mg/g Cr, respectively) than in group N (0.3 ± 0.1 and 7.5 ± 2.2, respectively). After CM infusion, uET/Cr in group R significantly increased, to 10.7 ± 2.6 mg/g Cr on the next day and returned to baseline level on the third day. NAG and β2M showed a similar pattern, but a significant change in NAG was observed on the second day in group R. In group N, uET/Cr, NAG, and β2M did not change after CM infusion. Plasma ET remained unchanged throughout the observation period of 4 days in both groups. No patient developed pulmonary edema or a significant rise in serum creatinine (more than 0.5 mg/dl), caused by infusion of the amount of half-normal saline used. Conclusions. 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.

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