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T. Almén
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Elmstahl B;Nyman U Leander;P. Chai;Golman K;Bjork J Almen;B. Elmståhl;U. Nyman;P. Leander;C. Chai;K. Golman;J. Björk;T. Almén
“钆造影剂比碘造影剂的肾毒性更大。渗透压在直接肾动脉注射中的重要性”欧洲放射学，2006年，问题：8月5日。1钆造影剂比碘造影剂的肾毒性更大。渗透压在直接肾动脉注射中的重要性。缺血性猪肾的肾毒性，I-CM、Gd-CM和甘露醇溶液，第23页，共2页摘要目的：研究缺血性猪肾中钆（Gd）和碘造影剂（CM）肾毒性中钆毒性的作用。材料和方法：供试品溶液：甘露醇与0.5M钆喷替酸盐（1.96 Osm/kg H2 O）、0.5M钆双胺（0.78 Osm/kg H2 O）和0.5M碘海醇（190 mg I/ml，0.42 Osm/kg H2 O）等渗。将每种溶液注射（3 ml/kg BW）到8只左侧肾切除猪的球囊闭塞（10分钟）右肾动脉中。GFR标志物的血浆半衰期用于比较它们在注射后1-3小时对GFR的影响。结果如下：注射钆喷替酸盐（1730 min）和甘露醇1.96 Osm/kg（2782 min）后GFR标志物的中位半衰期无统计学差异（p=0.28），但显著长于所有其他溶液（p<0.001）。钆双胺（218 min）和甘露醇0.82 Osm/kg（169 min）之间无显著差异（p=0.06），而碘海醇（181 min）和甘露醇0.43 Osm/kg（148 min）之间存在显著差异（p = 0.03）。钆双胺与碘海醇之间的差异具有显著性（p=0.01）。结论：作为肾毒性标志物，钆喷替酸盐诱导的GFR降低与其高渗透压相关，而钆双胺和碘海醇的作用可能包括化学毒性。碘海醇分子比Gd-CM分子的肾毒性更小，并且每个分子含有三倍于Gd-CM分子的衰减原子数。缺血性猪肾的肾毒性，I-CM、Gd-CM和甘露醇溶液，第/23页
"Gadolinium contrast media are more nephrotoxic than iodine media. The importance of osmolality in direct renal artery injections" European Radiology, 2006, Issue: aug 5. 1 Gadolinium contrast media are more nephrotoxic than iodine media. The importance of osmolality in direct renal artery injections. Nephrotoxicity to an ischemic porcine kidney, I-CM, Gd-CM and mannitol solutions, page out of 23 2 Abstract Purpose: To study the role of osmotoxicity in gadolinium (Gd) and iodine contrast media (CM) nephrotoxicity in ischemic porcine kidneys. Material and methods: Test solutions: mannitol iso-osmotic to 0.5M gadopentetate (1.96 Osm/kg H 2 O), 0.5M gadodiamide (0.78 Osm/kg H 2 O) and 0.5M iohexol (190 mg I/ml, 0.42 Osm/kg H 2 O). Each solution was injected (3 ml/kg BW) into the balloon-occluded (10-minutes) right renal artery of eight left-sided nephrectomized pigs. The plasma half-life of a GFR-marker was used to compare their effects on GFR 1-3 hours post-injection. Results: The median half-lives of the GFR marker after injection of gadopentetate (1730 min) and mannitol 1.96 Osm/kg (2782 min) did not differ statistically (p=0.28), but were significantly longer than after all other solutions (p<0.001). There was no significant difference (p=0.06) between gadodiamide (218 min) and mannitol 0.82 Osm/kg (169 min), while there was (p=0.03) between iohexol (181 min) and mannitol 0.43 Osm/kg (148 min). The difference between gadodiamide and iohexol was significant (p=0.01). Conclusions: Reduction in GFR, as a marker of nephrotoxicity, induced by gadopentetate correlated with its high osmolality, while the effect of gadodiamide and iohexol may include chemotoxicity. Iohexol molecules were less nephrotoxic than the Gd-CM molecules and contain three times the number of attenuating atoms per molecule. Nephrotoxicity to an ischemic porcine kidney, I-CM, Gd-CM and mannitol solutions, page out of 23