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Viscosity of Contrast Media Perturbs Renal Hemodynamics

Erdmann Seeliger^*, Bert Flemming^*, Thomas Wronski^*, Mechthild Ladwig^*, Karen Arakelyan^*,, Michael Godes^*, Martin Möckel and Pontus B. Persson^*

^* Institut für Vegetative Physiologie; and Medizinische Klinik–Kardiologie, Charité Universitätsmedizin Berlin, Berlin, Germany; and Physiology Department, Yerevan State Medical University, Yerevan, Armenia

Correspondence: Prof. Dr. Pontus B. Persson, Institut für Vegetative Physiologie, Humboldt Universität, Berlin, Medizinische Fakultät (Charité), Tucholskystrasse 2, 10117 Berlin, Germany. Phone: 49-30-450528-172; Fax: 49-30-450528-972; E-mail: pontus.persson{at}charite.de

Received for publication November 8, 2006. Accepted for publication June 19, 2007.

Contrast-induced nephropathy is a common cause of acute renal failure, and the mechanisms underlying this injury are not completely understood. We sought to determine how physicochemical properties of contrast media may contribute to kidney damage in rats. We administered contrast media of equivalent iodine concentrations but differing physiocochemical properties: the high-osmolality iopromide was compared to the high-viscosity iodixanol. In addition, the non-iodinated substances mannitol (equivalent osmolality to iopromide) and dextran (equivalent viscosity to iodixanol) were also studied. Both types of contrast media transiently increased renal and hindquarter blood flow. The high-osmolality agents iopromide and mannitol markedly increased urine production whereas iodixanol, which caused less diuresis, significantly enhanced urine viscosity. Only the high-viscosity agents iodixanol and dextran decreased renal medullary blood flux, erythrocyte concentration, and pO₂. Moreover, iodixanol prolonged the tubuloglomerular feedback response and increased plasma creatinine levels to a greater extent than iopromide or dextran. Therefore, the viscosity of contrast media may play a significant role in contrast-induced nephropathy.

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Copyright © 2008 by the American Society of Nephrology. Online ISSN: 1533-3450 Print ISSN: 1046-6673