Assessment of renal function in the early stages of nephrotoxicity inducedby iodinated contrast media

To determine whether there are early renal function parameters (RFP) which can be monitored to rapidly detect nephrotoxicity induced by contrast media (CM), we observed RFP in 16 patients with normal renal function before and after administration of CM, Forty-eight hours after diatrizoate meglumine administration, blood urea nitrogen (BUN) and serum creatinine (SCr) increa sed (p < 0.05). In all patients, acute tubular damage was revealed by early urinary RFP. Increases in levels of serum anglotensin-l-converting enzyme (ACE), beta(2)-microglobulin (beta(2)M) and urinary albumin (Alb) were asso ciated with alterations in glomerular function. The changes in early RFP oc curred earlier than those of BUN and SCr. The present study demonstrates th at serum ACE, beta(2)M, urinary Alb, gamma-glutamyl-transpeptidase and N-ac etyl-beta-D glucosidase are sensitive parameters for the early assessment o f subclinical nephrotoxicity induced by CM.