The Effect of Renal Artery Injection of Contrast Material on Urinary Enzyme Excretion

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Urinary excretion of lactic dehydrogenase, glutamate-oxaloacetale transaminase, creatine phosphokinase, and catalase was measured before and after the injection of 0.3 ml/kg of several contrast media or hypertonic control solutions into the renal artery of dogs. The contrast media studied were: 50% sodium diatrizoate, 50% sodium iothalamate, 60% meglumine iothalamate, and 16.7% sodium acetrizoate. The hypertonic solutions were 25% mannitol and 4.5% saline. The currently used contrast media and the hypertonic solutions caused a transient increase in urine enzyme excretion which could not be accounted for by the diuresis or the presence of red or white blood cells in the urine. Znzymuria in this model most likely results from mild degrees of renal tubule cell damage which is principally caused by the hypcrtonicity of the various agents. Acetrizoate, a known nephrotoxic contrast material was the only agent to cause a prolonged increase in enzyme excretion. The results indicate that the measurement of urine enzyme excretion is a sensitive means of assessing contrast media nephrotoxicity.

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