Clinical and experimental evidence for prevention of acute renal failure induced by radiographic contrast media

Yoshinori Itoh, Takahisa Yano, Toshiaki Sendo, Ryozo Oishi

Research output: Contribution to journalReview article

76 Citations (Scopus)

Abstract

Acute renal failure still occurs as a complication after radiographic examination using iodinated radiocontrast medium. The incidence rate of radiocontrast medium-induced nephropathy (radiocontrast nephropathy) is low (2-3%) in general. However, the rate is remarkably elevated in patients with pre-existing renal insufficiency. Radiocontrast nephropathy is associated with increased morbidity and mortality, particularly in patients with percutaneous coronary interventions. Although the reduction in renal blood flow and direct toxic action on renal tubular cells are considered to be involved, little is known about the etiology of radiocontrast nephropathy. A number of agents that improve renal circulation have been clinically tested for prevention of radiocontrast nephropathy, but none of them has succeeded. Protection of renal tubular cells against oxidative stress is another approach to avoid radiocontrast nephropathy. Prophylactic effects of antioxidants such as N-acetylcysteine and ascorbic acid have been reported by several investigators, although the effectiveness of these compounds is still a matter of debate. At present, hydration is regarded as the only effective, though incomplete, prophylactic regimen for radiocontrast nephropathy. Recently, we have shown that caspase-dependent apoptosis is an important factor in the pathogenesis of radiocontrast nephropathy and clarified cellular mechanisms underlying the radiocontrast media-induced apoptosis. This review summarizes clinical and experimental evidence for the etiology and prevention of radiocontrast nephropathy.

Original languageEnglish
Pages (from-to)473-488
Number of pages16
JournalJournal of Pharmacological Sciences
Volume97
Issue number4
DOIs
Publication statusPublished - Apr 1 2005
Externally publishedYes

Keywords

  • Apoptosis of renal tubular cells
  • Decrease in renal blood flow
  • Oxidative stress
  • Prophylaxis
  • Radiocontrast nephropathy

ASJC Scopus subject areas

  • Molecular Medicine
  • Pharmacology

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