Contrast Media Acute Renal Failure

  • Robert E. Cronin


Several observations point to the possibility that contrast-induced vascular alterations could be the common pathway for contrast-related cases of acute renal failure. Porter and Associates(1) noted that iothalamate, when injected into the left ventricle of the dog, resulted in an increase in cardiac output and caused a 25% decrease in renal blood flow. When isoosmolar quantities of mannitol were injected, however, the same increase in cardiac output occurred, but renal blood flow increased. Transient decreases in renal plasma flow and glomerular filtration rate occur after large-dose excretory urography.(2–4) In fact, noncontrast hypertonic solutions also produce this effect.(5) The response tends to be biphasic showing initially a transient increase in renal flood flow followed by a more prolonged (10–20%) decrease in renal blood flow which may persist for up to 1 hr.


Contrast Agent Multiple Myeloma Acute Renal Failure Renal Blood Flow Proximal Tubular Cell 
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  1. 1.
    Porter GA, Kloster FE, Bristow JD: Sequential effect of angiographic contrast agent on canine renal and systemic hemodynamics. Am Heart J 81:80, 1971.PubMedCrossRefGoogle Scholar
  2. 2.
    Talner LB, Davidson AJ: Renal hemodynamic effects of contrast media. Invest Rad 3:310, 1968.CrossRefGoogle Scholar
  3. 3.
    Donaldson IML: Comparison of the renal clearances of inulin and radioactive diatrizoate (“Hypaque”) as measures of the glomerular filtration rate in man. Clin Sci 35:513, 1968.PubMedGoogle Scholar
  4. 4.
    Gup AK, Schlegel JU: Physiologic effects of high dosage excretory urography. J Urol 100:85, 1968.PubMedGoogle Scholar
  5. 5.
    Chou CC, Hook JB, Hsieh CP, Burns TD, Dabney JM: Effects of radiopaque dyes on renal vascular resistance. J Lab Clin Med 78:705, 1974.Google Scholar
  6. 6.
    Russel SB, Sherwood T: Monomer/dimer contrast media in the renal circulation: experimental angiography. Br J Radiol 47:268, 1974.CrossRefGoogle Scholar
  7. 7.
    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, 1978.PubMedCrossRefGoogle Scholar
  8. 8.
    Sobin SS, Frasher WG, Johnson G: Nature of adverse reactions to radiopaque agents; preliminary report. JAMA 170:1546, 1959.CrossRefGoogle Scholar
  9. 9.
    Ekeland A, Uflacker R: Effect of meglumine metrizoate and metrizamide on the microcirculation. Acta Radiol Diag 19:969, 1978.Google Scholar
  10. 10.
    Endrich B, Ring J, Intaglietta M: Effect of radiopaque contast media on the microcirculation of the rabbit omentum. Diag Radiol 132:331, 1979.Google Scholar
  11. 11.
    Bernstein EF, Evans RL, Blum JA, Avant RF: Further experimental observations concerning the protective action of low molecular weight dextran upon intravenous hypaque toxicity. Radiology 76:260, 1961.Google Scholar
  12. 12.
    Schiantarelli P, Peroni F, Turone P, Rosati G: Effects of iodinated contrast media on erythrocytes. Invest Radiol 8:199, 1973.PubMedCrossRefGoogle Scholar
  13. 13.
    Healy JK: Acute oliguric renal failure associated with multiple myeloma: Report of three cases. Br Med J 1:1126, 1963.PubMedCrossRefGoogle Scholar
  14. 14.
    Rees ED, Waugh WH: Factors in renal failure in multiple myeloma. Arch Intern Med 116:400, 1965.PubMedCrossRefGoogle Scholar
  15. 15.
    Lasser EC, Lang JH, Zawadski ZA: Contrast media: myeloma protein precipitates in urography. JAMA 198:945, 1966.PubMedCrossRefGoogle Scholar
  16. 16.
    Myers GH, Witten DM: Acute renal failure after excretory urography in multiple myeloma. Am J Roentgenol 113:583, 1971.Google Scholar
  17. 17.
    McQueen EG: The nature of urinary casts. J Clin Pathol 15:367, 1962.PubMedCrossRefGoogle Scholar
  18. 18.
    Berdon WE, Schwartz RH, Becker J, Baker DH: Tamm-Horsfall proteinuria. Radiology 92:714, 1969.PubMedGoogle Scholar
  19. 19.
    Mudge GH: Uricosuric action of Cholangiographic agents: A possible factor in nephrotoxicity. N Engl J Med 284:929, 1971.PubMedCrossRefGoogle Scholar
  20. 20.
    Postlethwaite AE, Kelley WN: Uricosuric effect of radiocontrast agents: Study in man of four commonly used preparations. Ann Intern Med 74:845, 1971.PubMedGoogle Scholar
  21. 21.
    Feldman MA, Goldfarb S, McCurdy DK: Recurrent radiography dye-induced acute renal failure. JAMA 229:72, 1974.PubMedCrossRefGoogle Scholar
  22. 22.
    Gelman ML, Rowe JW, Coggins CH, Athanasoulis C: Effects of an angiographic contrast agent on renal function. Cardiovascular Med 4:313, 1979.Google Scholar
  23. 23.
    Kleinknecht D, Deloux J, Homberg JC: Acute renal failure after intravenous urography: Detection of antibodies against contrast media. Clin Nephrol 2:116, 1974.PubMedGoogle Scholar
  24. 24.
    Light JA, Perloff LJ, Etheredge EE, Hill G, Spees EK: Adverse effects of meglumine diatrizoate on renal function in the early post-transplant period. Transplantation 20:404, 1975.PubMedCrossRefGoogle Scholar
  25. 25.
    Heidemann M, Claes G, Nilson AE: The risk of renal allograft rejection following angiography. Transplantation 21:289, 1976.CrossRefGoogle Scholar
  26. 26.
    Brasch RC, Caldwell JL, Fundenberg HH: Antibodies to radiographic contrast agents. Induction and characterization of rabbit antibody. Invest Radiol 11:1, 1976.PubMedCrossRefGoogle Scholar
  27. 27.
    Lasser EC, Lee SH, Fisher E, Fisher B: Some further pertinent considerations regarding the comparative toxicity of contrast materials for the dog kidney. Radiology 78:240, 1962.PubMedGoogle Scholar
  28. 28.
    Holtas S, Almen T, Tejler L: Proteinuria following nephroangiography. II. Influence of contrast medium and catheterization in dogs. Acta Radiol Diag 19:33, 1978.Google Scholar
  29. 29.
    Holtas S, Tejler L: Proteinuria following nephroangiography. IV. Comparison in dogs between ionic and non-ionic contrast media. Acta Radiol Diag 20:13, 1979.Google Scholar
  30. 30.
    Teljer L, Almen T, Holtas S: Proteinuria following nephroangiography. I. Clinical experiences. Acta Radiol Diag 18:634, 1977.Google Scholar
  31. 31.
    Goldstein EJ, Feinfeld DA, Fleischner GM, Elkin M: Enzymatic evidence of renal tubular damage following renal angiography. Radiology 121:167, 1976.Google Scholar
  32. 32.
    Talner LB, Rushman HN, Coel MN: The effect of renal artery injection of contrast material on urinary enzyme excretion. Invest Radiol 7:311, 1972.PubMedCrossRefGoogle Scholar
  33. 33.
    Ziegler TW, Ladens JH, Fanestil DD, Talner LB: Inhibition of active sodium transport by radiographic contrast media. Kidney Int 7:68, 1975.PubMedCrossRefGoogle Scholar
  34. 34.
    Moreau JF, Diaz D, Sabato J, Jungers P, Kleinknecht D, Hinglais N, Michel JR: Osmotic nephrosis induced by water soluble triiodinated contrast media in man. Radiology 115:329, 1975.PubMedGoogle Scholar
  35. 35.
    Blaufox MD, Sanderson DR, Tauxe WN, Wakim KG, Orvis AL, Owen CA Jr: Plasmatic Diatrizoate I131 and glomerular filtration in the dog. Am J Physiol 204:536, 1963.PubMedGoogle Scholar
  36. 36.
    Denneberg T: Clinical studies of kidney function with radioactive sodium diatrizoate (Hypaque). Acta Med Scand 179(suppl 442):1, 1966.Google Scholar
  37. 37.
    Stokes JM, Conklin JW, Huntley HC: Measurement of glomerular filtration rate by contrast media containing I131 isotopes. J Urol 87:630, 1962.PubMedGoogle Scholar
  38. 38.
    Golman K, Denneberg T, Nosslin B: Metrizamide in urography. II. A comparison of 51Cr EDTA clearance and metrizamide clearance in man. Invest Radiol 12:353, 1977.PubMedCrossRefGoogle Scholar
  39. 39.
    Golman K, Scient C: Metrizamide in experimental urography. V. Renal excretion mechanism of a non-ionic contrast medium in rabbit and cat. Invest Radiol 11:187, 1976.PubMedCrossRefGoogle Scholar
  40. 40.
    Golman K, Almen T: Metrizamide in experimental urography. VI. Effect of renal contrast media on urinary solutes. Acta Pharmacol Toxicol 38:120, 1976.CrossRefGoogle Scholar
  41. 41.
    McChesney EW: The biotransformation of iodinated radiocontrast agents, in Knoefel PK (ed): International Encyclopedia of Pharmacology and Therapeutics. Section 76. Radio contrast agents. New York, Pergamon Press, Vol 1, 1971, pp 147–163.Google Scholar
  42. 42.
    Bricker NS, Hlad CJ. Observations on the mechanism of the renal clearance of I131. J Clin Invest 34:1057, 1955.PubMedCrossRefGoogle Scholar
  43. 43.
    Cassidy CE: The duration of increased serum iodine concentration after ingestion of Bunamiodyl (Orabilex). J Clin Endocrinol 20:1034, 1960.CrossRefGoogle Scholar
  44. 44.
    Swartz RD, Rubin JE, Lemming BW, Silva P: Renal failure following major angiography. Am J Med 65:31, 1978.PubMedCrossRefGoogle Scholar
  45. 45.
    Harkonen S, Kjellstrand CM: Exacerbation of diabetic renal failure following intravenous pyelography. Am J Med 63:939, 1977.PubMedCrossRefGoogle Scholar

Copyright information

© Plenum Publishing Corporation 1985

Authors and Affiliations

  • Robert E. Cronin
    • 1
  1. 1.Veterans Administration Medical CenterUniversity of Texas Southwestern Medical SchoolDallasUSA

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