NEPHROTOXICITY FROM CONTRAST-MEDIA - ATTENUATION WITH THEOPHYLLINE

PURPOSE: To determine if depression of creatinine clearance after admi nistration of contrast medium may be prevented with theophylline. MATE RIALS AND METHODS: A nonionic, low-osmolality contrast medium (iopamid ol) or an ionic, high-osmolality contrast medium (sodium diatrizoate) was administered to 93 patients. Before the examination, these patient s were given theophylline or a placebo orally. There were also 30 pati ents who received an adenosine-uptake inhibitor (dipyridamole). Creati nine clearance and urinary adenosine levels were measured before and a fter angiography. RESULTS: Creatinine clearance decreased 18% +/- 4 in the placebo-iopamidol group but did not decrease in the theophylline group; urinary adenosine increased 67% +/- 7. Creatinine clearance dec reased 42% +/- 5 in the placebo-sodium diatrizoate group and decreased 24% +/- 3 in the theophylline group; urinary adenosine increased 119% +/- 8. In the dipyridamole group in which iopamidol was given, urinar y adenosine increased 96% +/- 7 and creatinine clearance decreased 37% +/- 5. CONCLUSION: Intrarenal adenosine can be implicated in the path ogenesis of hypertonic contrast medium nephrotoxicity.