Histological study of early and late nephrotoxicity and endothelial cytotoxicity of ionic and non-ionic contrast media

ABSTRACT

The Structural changes induced by the use of radiopaque contrast media have been investigated using light and electron microscopic techniques. Three groups of adult male rats were used in this study. The first group [n=15] was injected intravenously with urographin in a dose of 0.5 ml/kg body weight. The second group [n=15] was injected with a similar dose of iopamidol. The third group [n=15] served as control. Specimens from the kidney and inferior vena cava were taken after 3,7 and 14 days of injection. Glomerular and tubular changes of the kidney and the endothelium of the inferior vena cava were evident after the use of both types of media. However, the effect was more pronounced and persistent after the use of ionic media. The results indicate that the tubular effect of the ionic media is secondary to its high osmolality and not to its inherent chemotoxicity. On the other hand, a chemotoxic effect on the glomerular epithelial cells [podocytes] is suggested. In addition, ischemia of the kidney is another factor that contributes to the nephrotoxic effect of the ionic media. Contrast media influenced the endothelium of the inferior vena cava indicating that the effect on the vascular endothelium extends to involve vessels distant from the site of injection