Contrast media-induced renal morphologic lesions during experimental hemorrhagic necrotizing pancreatitis

Abstract

Rationale and objectives: Contrast media-induced renal morphologic changes were studied in rats. Hemorrhagic pancreatitis was induced as a means of sensitizing the animals to the effects of contrast media.

Methods: The histologically verified hemorrhagic pancreatitis was induced in Wistar rats (n = 66) by injecting 6% sodium taurocholate into the pancreatic duct. After 2 hours, the animals received intravenously 1.0 or 3.0 g iodine/kg of high-osmolal osmolal diatrizoate, low-osmolal iopromide or iohexol, iso-osmolal iotrolan or 0.2 or 0.6 g/kg of high-osmolal magnetic resonance contrast agent, gadolinium-DTPA (Gd-DTPA). Control animals received physiologic saline. The kidneys were fixed by perfusion 2 hours later, and the morphologic changes were reviewed by two independent observers blinded to the injected agent.

Results: The smaller dose of iohexol and the larger dose of all the contrast media induced a statistically significant (P < .001 or .01) cytoplasmic vacuolization in the proximal convoluted tubule (PCT) cells. The nonionic, low- and iso-osmolal contrast media caused as much or even significantly more vacuolization than diatrizoate.

Conclusions: Hemorrhagic pancreatitis potentiates the contrast media-induced renal morphologic changes, which depend on the type and dose of the injected contrast media.