ANALYSIS OF RADIOCONTRAST-INDUCED NEPHROPATHY BY DUAL-LABELED RADIONUCLIDE CLEARANCE

RATIONALE AND OBJECTIVES. This study was devised to develop a method o f measuring the acute effects of radiocontrast media on renal function and assessing the relationship of the dose of radiocontrast media inf used with the incidence of radiocontrast-induced renal failure. In add ition, the drug adenosine phosphate-magnesium chloride (ATP-MgCl2) was evaluated as a renoprotective agent. METHODS. Eighteen patients with pre-existing renal impairment, (serum creatinine greater than 133 mu m ol/L) were randomized to receive a continuous infusion of ATP-MgCl2 or placebo before and during a radiocontrast procedure. Subjects were mo nitored with daily serum creatinine and with radionuclide renal cleara nce studies at baseline, during, and 24 hours after the radiocontrast procedure. RESULTS. There was an initial deterioration in renal cleara nce in the entire study group (from 44.2 +/- 4.6 to 32.6 +/- 3.9 mL/mi n, P = .001) which was independent of the dose of radiocontrast infuse d. There was a persistent deterioration in renal clearance only in tho se who received greater than 135 mL of contrast media (from 48.6 +/- 7 .8 to 37.1 +/- 3.9 mL/min, P = .05). There also was an increase in ser um creatinine that persisted only in those subjects who received great er than 135 mt of contrast media (230 +/- 27 to 283 +/- 44 mu mol/L, P = .01). CONCLUSION. Persistent deterioration in renal function after radiocontrast administration appears to be dose-dependent