Induction and prevention of radiocontrast-induced nephropathy in dogs with heart failure

• Published in: Kidney international Vol. 38; no. 6; pp. 1101 - 1108
• Main Authors: Margulies, Kenneth B., Mckinley, Linda J., Cavero, Patricia G., Burnett, John C.
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01-12-1990; Nature Publishing
• Subjects: Acute Kidney Injury - chemically induced; Acute Kidney Injury - prevention & control; Animals; Atrial Natriuretic Factor - therapeutic use; Biological and medical sciences; Cardiac Pacing, Artificial; Contrast Media - toxicity; Dogs; Drug Combinations; Drug toxicity and drugs side effects treatment; Female; Glomerular Filtration Rate - drug effects; Heart Failure - etiology; Heart Failure - physiopathology; Iothalamate Meglumine - toxicity; Iothalamic Acid - toxicity; Male; Medical sciences; Pharmacology. Drug treatments; Toxicity: urogenital system; Heart failure; Fissipedia; Carnivora; Urinary system disease; Intravenous administration; Toxicity; Acute; Cardiovascular disease; Atrial natriuretic peptide; Prevention; Vertebrata; Chemotherapy; Mammalia; Treatment; Animal; Renal failure; Dog; Contrast media
• ISSN: 0085-2538; 1523-1755
• DOI: 10.1038/ki.1990.319

Induction and prevention of radiocontrast-induced nephropathy in dogs with heart failure. Radiocontrast-induced nephropathy (RCIN) is a clinically important cause of acute renal failure with no effective treatment. Recognizing the high incidence of RCIN in humans with severe congestive heart failure (CHF), this study was designed to test the hypotheses that dogs with experimental CHF are at increased risk for RCIN and that pharmacologic renal levels of atrial natriuretic factor (ANF) can prevent RCIN in this model. In chronic experiments, three groups of five conscious dogs received intravenous radiocontrast (7 ml/kg). One group consisted of normal controls, while the two other groups had experimental CHF induced by eight days of ventricular pacing at 250 beats per minute. One of the CHF groups received an infusion of ANF (30 ng/kg/min) into the suprarenal aorta for one hour before, during and after the infusion of radiocontrast to achieve pharmacologic renal plasma levels. Renal function remained stable in the normal controls in contrast to the consistent decreases in daily creatinine clearance during the five days following radiocontrast in experimental CHF. In addition, ANF prevented radiocontrast-induced reductions in creatinine clearance in dogs with experimental CHF. Additional studies performed in two groups of anesthetized dogs with experimental CHF demonstrated that, in this model of RCIN, the reduction in renal function appears biphasic, and the action of ANF may be to increase glomerular filtration rate prior to radiocontrast, thus allowing a maintenance of renal function during and after radiocontrast.