Patients with cirrhosis are frequently submitted to radiological procedures th at require the administration of contrast media. Contrast media is a well-known cause of renal failure, particularly in the presence of so...Patients with cirrhosis are frequently submitted to radiological procedures th at require the administration of contrast media. Contrast media is a well-known cause of renal failure, particularly in the presence of some predisposing condi tions. However, it is not known whether cirrhosis constitutes a risk factor for contrast media-induced renal failure. The aim of this study was to assess the p ossible nephrotoxicity of contrast media in patients with cirrhosis. In a first protocol, renal function was evaluated with sensitive methods (glomerular filtra tion rate using iothalamate I 125 clearance and renal plasma flow using iodohipp urate I 131 clearance) before and 48 hours after the administration of contrast media in 31 patients with cirrhosis (20 with ascites, 5 with renal failure). Sol ute-free water clearance, urine sodium, prostaglandins, and markers of tubular damage were also measured. The administration of contrast media was not associat ed with significant changes in renal function tests, neither in the whole group of patients nor in patients with ascites or renal failure. Urinary prostaglandin E2 and N-acetyl-β-D-glucosaminidase increased signi ficantly, but sodium and solute-free water excretion remained unchanged. In a second protocol, a different series of 60 patients with cirrhosis and renal fai lure were examined prospectively. No patient had renal failure due to contrast m edia. Only in 1 patient with septic shock was contrast media a possible contribu ting factor. In conclusion, the administration of contrast media is not associat ed with adverse effects on renal function in patients with cirrhosis. Cirrhosis does not appear to be a risk factor for the development of contrast media-induc ed nephrotoxicity.展开更多
文摘Patients with cirrhosis are frequently submitted to radiological procedures th at require the administration of contrast media. Contrast media is a well-known cause of renal failure, particularly in the presence of some predisposing condi tions. However, it is not known whether cirrhosis constitutes a risk factor for contrast media-induced renal failure. The aim of this study was to assess the p ossible nephrotoxicity of contrast media in patients with cirrhosis. In a first protocol, renal function was evaluated with sensitive methods (glomerular filtra tion rate using iothalamate I 125 clearance and renal plasma flow using iodohipp urate I 131 clearance) before and 48 hours after the administration of contrast media in 31 patients with cirrhosis (20 with ascites, 5 with renal failure). Sol ute-free water clearance, urine sodium, prostaglandins, and markers of tubular damage were also measured. The administration of contrast media was not associat ed with significant changes in renal function tests, neither in the whole group of patients nor in patients with ascites or renal failure. Urinary prostaglandin E2 and N-acetyl-β-D-glucosaminidase increased signi ficantly, but sodium and solute-free water excretion remained unchanged. In a second protocol, a different series of 60 patients with cirrhosis and renal fai lure were examined prospectively. No patient had renal failure due to contrast m edia. Only in 1 patient with septic shock was contrast media a possible contribu ting factor. In conclusion, the administration of contrast media is not associat ed with adverse effects on renal function in patients with cirrhosis. Cirrhosis does not appear to be a risk factor for the development of contrast media-induc ed nephrotoxicity.
