Study on free enzymes and proteins in the urine. Report IV: The effects of Iohexol on elderly patients with renal function disorder
Fukui, J.; Yasumoto, R.; Kishimoto, T.; Kobayakawa, H.; Gotou, T.; Eguchi, J.; Iseki, T.; Nishio, S.
Hinyokika Kiyo. Acta Urologica Japonica 40(6): 549-553
1994
ISSN/ISBN: 0018-1994 PMID: 7915490 Document Number: 429264
We assessed the nephrotoxicity of a non-ionic contrast medium, Iohexol, in 18 elderly patients. They were divided into two groups. Group 1 consisted of 12 patients with glomerular flow rate (GFR) above 60 ml/min/1.73 ml (range 69 apprx 136; average 96) and group 2 consisted of 6 patients with GFR below 60 ml/min/1.73 ml (range 38 apprx 59; average 49). Urine samples, collected before, immediately after, and on the third and sixth days after drip infused pyeloureterography (DIP) were analyzed for gamma-glutamyl transpeptidase (gamma-GTP), N-acetyl-beta-D-glucosaminidase (NAG), beta-2-microglobulin (beta-2-MG) and albumin. In group 1, immediately after DIP, the urinary excretion of albumin, gamma-GTP and NAG were significantly increased (p lt 0.01, p lt 0.01, p lt 0.01). In group 2, immediately after DIP, the urinary excretion of gamma-GTP and beta-2-MG were significantly increased (p lt 0.01, p lt 0.1). The gamma-GTP and NAG values in both groups suggest that the damage of proximal tubules cells will not continue for more than 4 days. However, as for the reabsorption of beta-2-MG on proximal tubules, in group 2 the value did not return to the pre DIP level until 6 days after DIP. We believe it is important to postpone injection of non-ionic contrast medium within 6 days of its last usage.