M. Hentschel et al., ENDOTHELIN (ET-1) IS INVOLVED IN THE CONTRAST-MEDIA INDUCED NEPHROTOXICITY IN CHILDREN WITH CONGENITAL HEART-DISEASE, Clinical nephrology, 43, 1995, pp. 12-15
In 77 children with congenital heart disease urinary endothelin-1 (ET-
1), an indicator of intrarenal endothelin release, was compared to uri
nary excretion of total protein, albumin, immunoglobuline G (IgG), alp
ha(1)-microglobuline (alpha(1)-MG), N-acetyl-beta-D-glucosaminidase (N
AG) and villin. Urine samples were collected the day before and immedi
ately after cardiac angiography with high (Conray 70; n = 56; CON) or
low osmolality contrast media (Solutrast 300; n = 21; SOL) to assess t
he relationship between urinary endothelin and glomerular and tubular
nephrotoxicity of contrast media. The children were further subdivided
according to age: less than 1 year - CON 1 (n = 20); SOL 1 (n = 12) a
nd 1 - 18 years CON 2 (n = 36); SOL 2 (n = 9). Results (median): 1. Th
ere are no significant changes in total protein-, albumin- and IgG-exc
retion as parameters of glomerular toxicity. 2. Tubular toxicity of co
ntrast media is shown by significant increase of alpha(1)-MG-(10.0 to
23.2 mg/g Crea; p < 0.001), NAG-(5.9 to 9.6 mg/g Crea; p < 0.001) and
Villin-excretion (1.0 to 2.0 STS, p < 0.001) in all children. 3. Endot
helin excretion (101.0 to 163.0 ng/g Crea, p < 0.001) and concentratio
n (42.5 to 56.0 pg/ml; p < 0.001) were elevated after angiography in a
ll children. 4. The changes in endothelin excretion are correlated to
the changes in alpha(1)-MG (r = 0.65; p < 0.001) and NAG (r = 0.43, p
< 0.001) in all children. Particular in children less than 1 year high
er correlation coefficiants to alpha(1)-MG are shown (CON 1: r = 0.65;
p < 0.01 and SOL 1: r = 0.86; p < 0.001). 5. Regarding the tubular to
xicity there was no difference between high or low osmolar contrast me
dia. 6. Tubular damage was not correlated to dosage of contrast media.