Is contrast medium osmolality a causal factor for contrast-induced nephropathy?

Andreas M. Bucher, Carlo N. De Cecco, U. Joseph Schoepf, Felix G. Meinel, Aleksander W. Krazinski, James V. Spearman, Andrew D. McQuiston, Rui Wang, Judith Bucher, Thomas J. Vogl, Richard W Katzberg

Research output: Contribution to journalReview article

23 Scopus citations

Abstract

The exact pathophysiology of contrast-induced nephropathy (CIN) is not fully clarified, yet the osmotic characteristics of contrast media (CM) have been a significant focus in many investigations of CIN. Osmotic effects of CM specific to the kidney include transient decreases in blood flow, filtration fraction, and glomerular filtration rate. Potentially significant secondary effects include an osmotically induced diuresis with a concomitant dehydrating effect. Clinical experiences that have compared the occurrence of CIN between the various classes of CM based on osmolality have suggested a much less than anticipated advantage, if any, with a lower osmolality. Recent animal experiments actually suggest that induction of a mild osmotic diuresis in association with iso-osmolar agents tends to offset potentially deleterious renal effects of high viscosity-mediated intratubular CM stagnation.

Original languageEnglish (US)
Article number931413
JournalBioMed Research International
Volume2014
DOIs
StatePublished - 2014
Externally publishedYes

ASJC Scopus subject areas

  • Immunology and Microbiology(all)
  • Biochemistry, Genetics and Molecular Biology(all)

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    Bucher, A. M., De Cecco, C. N., Schoepf, U. J., Meinel, F. G., Krazinski, A. W., Spearman, J. V., McQuiston, A. D., Wang, R., Bucher, J., Vogl, T. J., & Katzberg, R. W. (2014). Is contrast medium osmolality a causal factor for contrast-induced nephropathy? BioMed Research International, 2014, [931413]. https://doi.org/10.1155/2014/931413