HEMODIALYSIS FOR ELIMINATION OF THE NONIONIC CONTRAST-MEDIUM IOHEXOL AFTER ANGIOGRAPHY IN PATIENTS WITH IMPAIRED RENAL-FUNCTION

被引:57
作者
MOON, SS
BACK, SE
KURKUS, J
NILSSONEHLE, P
机构
[1] LUND UNIV,DEPT NEPHROL,S-22100 LUND,SWEDEN
[2] LUND UNIV,DEPT CLIN CHEM,S-22100 LUND,SWEDEN
来源
NEPHRON | 1995年 / 70卷 / 04期
关键词
CONTRAST MEDIA NEPHROPATHY; HEMODIALYSIS; IOHEXOL; RADIOGRAPHIC AGENTS;
D O I
10.1159/000188641
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
We examined the kinetics of contrast agent elimination during hemodialysis in 7 patients with end-stage renal disease on regular hemodialysis treatment (group I) and in 13 patients with impaired renal function (serum creatinine 214-657 mu mol/l; group II). The nonionic agent iohexol was administered at a dose of 0.4-4.5 g/kg and a 6-hour hemodialysis was performed with 1-18 h delay. This procedure removed 60-90% (mean 77%) of the iohexol present in the circulation at the start of dialysis treatment. The mean extraction ratio across the dialysis membrane was 0.47 and was inversely related to blood flow. The total clearance of iohexol was 70.4 +/- 24.6 ml/min and was very close to dialyzer clearance, as estimated from blood flow and extraction ratio. The plasma iohexol level after dialysis was related to the dose administered, iohexol clearance, and the patients' body weight. During peritoneal dialysis (36-60 liters dialysis fluid), 43-72% of the iohexol dose was removed from the patients' circulation. In patients of group II no further impairment of the renal function (increase of serum creatinine) in conjunction with angiography was observed. We conclude that hemodialysis and peritoneal dialysis are effective methods for removal of iohexol. Our observations suggest also that accelerated elimination of contast media by prophylactic dialysis can be beneficial in preventing further reduction in renal function after angiographic procedures in high-risk patients.
引用
收藏
页码:430 / 437
页数:8
相关论文
共 26 条
[1]   ACUTE RENAL-FAILURE ASSOCIATED WITH IOXAGLATE, A LOW-OSMOLALITY RADIOCONTRAST AGENT [J].
ARON, NB ;
FEINFELD, DA ;
PETERS, AT ;
LYNN, RI .
AMERICAN JOURNAL OF KIDNEY DISEASES, 1989, 13 (03) :189-193
[2]  
BAARS HG, 1984, Z UROL NEPHROL, V77, P473
[3]   ELIMINATION OF IODINE-CONTAINING CONTRAST-MEDIA BY HEMODIALYSIS [J].
BAHLMANN, J ;
KRUSKEMPER, HL .
NEPHRON, 1973, 10 (04) :250-255
[4]   EXCRETION OF IODINE-CONTAINING X-RAY CONTRAST MEDIA BY PERITONEAL DIALYSIS IN ACUTE AND CHRONIC RENAL FAILURE [J].
BAHLMANN, J ;
KLUGE, R ;
KRUSKEMPER, HL .
ZEITSCHRIFT FUR DIE GESAMTE EXPERIMENTELLE MEDIZIN EINSCHLIESSLICH EXPERIMENTELLER CHIRURGIE, 1970, 152 (04) :325-+
[5]  
Bakris George L., 1993, P361
[6]   NEPHROTOXICITY OF CONTRAST-MEDIA [J].
BERNS, AS ;
KANTER, A ;
COHEN, JJ ;
GARELLA, S ;
SIMON, N ;
DUFFY, B ;
SPRAGUE, S ;
LAU, K .
KIDNEY INTERNATIONAL, 1989, 36 (04) :730-740
[7]   TUBULAR NEPHROTOXICITY AFTER INTRAVENOUS UROGRAPHY WITH IONIC HIGH-OSMOLAL AND NONIONIC LOW-OSMOLAL CONTRAST-MEDIA IN PATIENTS WITH CHRONIC RENAL-INSUFFICIENCY [J].
CAVALIERE, G ;
ARRIGO, G ;
DAMICO, G ;
BERNASCONI, P ;
SCHIAVINA, G ;
DELLAFIORE, L ;
VERGNAGHI, D .
NEPHRON, 1987, 46 (02) :128-133
[8]   NEPHROTOXICITY FROM ANGIOGRAPHIC CONTRAST MATERIAL - A PROSPECTIVE-STUDY [J].
DELIA, JA ;
GLEASON, RE ;
ALDAY, M ;
MALARICK, C ;
GODLEY, K ;
WARRAM, J ;
KALDANY, A ;
WEINRAUCH, LA .
AMERICAN JOURNAL OF MEDICINE, 1982, 72 (05) :719-725
[9]   IOHEXOL AND METRIZOATE IN UROGRAPHY OF INSULIN-DEPENDENT PATIENTS [J].
EDGREN, J ;
LAASONEN, L ;
GROOP, PH ;
GROOP, L .
ACTA RADIOLOGICA-DIAGNOSIS, 1986, 27 (03) :265-267
[10]  
GOLMAN K, 1985, INVEST RADIOL, V20, P92