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Kidney Week

Abstract: TH-PO079

Renal Events Following Iodinated Contrast Aggravate Diabetic Nephropathy

Session Information

Category: Acute Kidney Injury

  • 101 AKI: Epidemiology, Risk Factors, and Prevention

Authors

  • Fernandes, Sheila Marques, University of São Paulo, Carapicuíba, Brazil
  • Brandi, Beatriz De almeida, Universidade de São Paulo, São Paulo, Brazil
  • Peres, Karina Batista, EEUSP, São Paulo, Brazil
  • Santos, Luciana soares Costa, Universidade de São Paulo, São Paulo, Brazil
  • da Fonseca, Cassiane Dezoti, Federal University of Sao Paulo, Sao Paulo, SP, Brazil
  • Watanabe, Miriam M., Faculdades Metrpolitana Unidas, São Paulo, Brazil
  • Vattimo, Maria De Fatima, Universidade de São Paulo, São Paulo, Brazil

Group or Team Name

  • Group of Studies on Acute Kidney Injury (GERA)
Background

Iodinated contrast (IC) is a leading cause of AKI (CI-AKI) and occurs more frequently in individuals with increasingly common risk factors, including diabetes. IC-AKI has been growing in recent years faced with the more frequent diagnostic needs in old patients and with comorbid conditions such as diabetes. This complication is due to a number of factors, including the osmolality of the IC.
The aim of this study is to evaluate the injury in kidneys of diabetic rats submitted to treatment with high- osmolar and low-osmolar iodinated contrast, evaluating the impact on hemodynamic and renal function in addition to oxidative profile.

Methods

Wistar rats, male and adult, weighing 250-290g were randomized into four groups: Citrate, Diabetes Mellitus (DM), Diabetes+low-osmolar iodinated contrast (DM+LIC) and DM+high-osmolar iodinated contrast (DM+HIC). Physiological parameters (body weight, water and food intake, glycemia and kidney/body weight ratio); renal function (Inulin Clearance; urinary neutrophil gelatinase/uNGAL); hemodynamics (arterial blood pressure; renal blood flow/RBF; renal vascular resistance/RVR) and oxidative profile (urinary peroxides/UP, urinary TBARS, renal tissue thiols and urinary nitric oxide/NO) were evaluated.

Results

Diabetic groups showed polyphagia, polydipsia, polyuria, high levels of blood glucose and reduction in body weight. DM group showed a reduced inulin clearance, elevated uNGAL, elevated RVR, reduced RBF, elevated UP, TBARS and NO and a consumption of antioxidant reserve. When IC was introduced, the parameters of renal function, renal hemodynamic and oxidative profile became worse, specially in the group DM+HIC.

Conclusion

The use of high and low osmolarity IC promoted additional deleterious action to renal function and hemodynamics with oxidative injury in diabetic rats, with a more expressive effect in the group submitted to high osmolality contrast treatment.

Renal function, hemodynamics, oxidative
Group (n)Serum creatinine (mg/min/kg)Inulin clearance (mL/min/kg)Neutrophil gelatinase-associated lipocalin (ng/mL)Renal blood flow (mL/min)Renal vascular resistance (mmHg/mL/min)Urinary peroxides (nmol/g creatinine)TBARS (nmol/g creatinine)Thiols (nmol/mg potein)Nitric oxide (µM/g creatinine)
Citrate (7)0.30±0,060.94±0.2341.41±4.638.19±0.7615.05±2.002.15±0.850.16±0.0430.92±7.4425.06±4.05
DM (7)0.80±0,25 *0.58±0.05 *57.25±14.443.96±0.70*26.34±5.60 *12.74±3.94 *1.09±0.28*15.75±1.17 *53.72±5.31 *
DM+LIC0.87±0,11 *#0.34±0.11 *#103.78±9.09 *#3.06±0.42 *#35.42±6.35 *#18.94±7.54 *#2.13±0.46 *#12.50±3.64 *#76.78±8.47 *#
DM+HIC1.47±0,66 *#&0.14±0.01 *#&167.27±8.50 *#&2.29±0.55 *#&44.97±6.06 *#&25.57±7.54 *#&3.31±0.47 *#&6.22±0.31 *#&88.23±8.47 *&

* p<0.05 versus Citrate; # p<0.05 versus DM; & p<0.05 versus DM+LIC

Funding

  • Government Support - Non-U.S.