Abstract
Newer contrast agents have recently been developed to improve patient safety and imaging quality. This survey examines renal handling of contrast media, mechanisms of contrast enhancement and questions related to renal toxicity. Methods to minimize contrast-medium-induced acute renal failure are suggested. The introduction of low osmolality contrast media promises reduced patient risk and improved renal enhancement.
Similar content being viewed by others
References
Morris TW, Fischer HW: The pharmacology of intravascular radiocontrast media.Annu Rev Pharmacol Toxicol 26:143–160, 1986
Katzberg RW, Pabico RC, Morris TW, Hayakawa K, McKenna BA, Panner BJ, Ventura JA, Fischer HW: Effects of contrast media on renal function and sub-cellular morphology in the dog.Invest Radiol 21:64–70, 1986
Newhouse JH: Fluid compartment distribution of intravenous iothalamate in the dog.Invest Radiol 12:364–367, 1977
Dean PB, Kivisaari L, Kormano M: The diagnostic potential of contrast enhancement pharmacokinetics.Invest Radiol 13:533–540, 1978
Ekholm SE: Adverse reactions to intravascular and intrathecal contrast media. Iatrogenic diseases.Crit Rev Diagn Imaging (In press).
Katzberg RW: Intravascular contrast media. In Putman CE, Ravin CE (eds):Diagnostic Imaging. Philadelphia: WB Saunders, 1987
Mudge GH: The maximal urinary concentration of diatrizoate.Invest Radiol 15 (Suppl):S67-S78, 1980
Spataro RF, Fischer HW, Boylan L: Urography with low-osmolality contrast media. Comparative urinary excretion of Iopamidol, Hexabrix, and Diatrizoate.Invest Radiol 17:494–500, 1982
Benness GT: Urographic contrast agents: a comparison of sodium and methylglucamine salts.Clin Radiol 21:150, 1970
Sherwood T, Lavender JP: Does renal blood flow rise or fall in response to diatrizoate?Invest Radiol 5:327–328, 1969
Caldicott WJH, Hollenberg NK, Abrams HL: Characteristics of response of renal vascular bed to contrast media: evidence of vasoconstriction induced by renin-angiotensin system.Invest Radiol 5:539–547, 1970
Katzberg RW, Schulman G, Meggs LG, Caldicott WJH, Damiano MM, Hollenberg NK: Mechanism of the renal response to contrast medium in dogs. Decrease in renal function due to hypertonicity.Invest Radiol 18:74–80, 1983
Morris TW, Katzberg RW, Fischer HW: A comparison of the hemodynamic responses to metrizamide and meglumine/sodium diatrizoate in canine renal angiography.Invest Radiol 13:74–78, 1978
Törnquist C: Nephrotoxicity of ionic and nonionic contrast media in experimental and clinical nephroangiography. With special reference to ionic diatrizoate and metrizoate and nonionic iohexol. Thesis, Malmö, Sweden, 1985
Morris TW, Harnish PP, Reece K, Katzberg RW: Tissue fluid shifts during renal arteriography with conventional and low osmolality agents.Invest Radiol 18:335–340, 1983
Gennari FJ, Kassirer JP: Osmotic diuresis.N Engl J Med 291:714–720, 1974
Gottschalk CW, Mylle M: Micropuncture study of pressures in proximal and distal tubules and peritubular capillaries of the rat kidney during osmotic diuresis.Am J Physiol 189:323–328, 1975
Katzberg RW, Morris TW, Schulman G, Caldicott WJH, Boyzan LM, Foley MJ, Spataro RF, Fischer HW: Reaction to intravenous contrast media. Part II: Acute renal response in euvolemic and dehydrated dogs.Radiology 147:331–334, 1983
Harvey LA, Caldicott WJH: The influence of contrast medium dose on filtration fraction in the rabbit kidney.Invest Radiol 18:441–444, 1983
Byrd L, Sherman RL: Radiocontrast-induced acute renal failure: a clinical and pathophysiologic review.Medicine 58:270–279, 1979
Holtas S, Törnquist C: Renal complications of contrast media. In Ansell G (ed):Complications in Radiology. (In press).
Mudge GH: Nephrotoxicity of urographic contrast drugs.Kidney Int 18:540–552, 1980
Tejler L, Almén T, Holtas S: Proteinuria following nephroangiography. I. Clinical experiences.Acta Radiol (Diagn) 18:634–640, 1977
Holtas S, Almén T, Hellsten S, Tejler L: Proteinuria following nephroangiography. VI. Comparison between metrizoate and metrizamide in man.Acta Radiol (Diagn) 21:491–494, 1980
Hartman HG: Enzymuria after administration of water-soluble x-ray contrast media. In Taenzer V, Zeitler E (eds):Contrast Media. Stuttgart: Georg Thieme Verlag, 1983, pp 30–36
Moreau J-F, Droz D, Noel L-H, Leibowitch J, Jungers P, Michel J-R: Tubular nephrotoxicity of water-soluble iodinated contrast media.Invest Radiol 15 (Suppl):554–560, 1980
Humes HD, Hunt DA, White MD: Direct toxic effect of the radiocontrast agent diatrizoate on renal proximal tubule cells.Am J Physiol 252:F246-F255, 1987
Spataro RF, Katzberg RW, Fischer HW, et al: High dose clinical urography with the low osmolality contrast agent Hexabrix: comparison with a conventional contrast agent.Radiology 162:9–14, 1987
Schrott KM, Behrends B, Klaus W, et al: Drig monitoring fur 50 BZW 100 ml omnipaque 300 in der ausscheidung urographie.Urologie B 25:24, 1985
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Katzberg, R.W. New and old contrast agents: Physiology and nephrotoxicity. Urol Radiol 10, 6–11 (1988). https://doi.org/10.1007/BF02926527
Issue Date:
DOI: https://doi.org/10.1007/BF02926527