Effect of iodinated contrast media on the oxygen tension in the renal cortico-medullary region of pigs

Issue title: Selected papers of the 38th Conference of the German Society for Clinical Microcirculation and Hemorheology, 21-23 November 2019, Braunschweig, Germany

Guest editors: P. Wiggermann, A. Krüger-Genge and F. Jung

Article type: Research Article

Authors: Lamby, P.^{a; *} | Krüger-Genge, A.^b | Franke, R.P.^c | Mrowietz, C.^d | Falter, J.^a | Graf, S.^a | Schellenberg, E.L.^e | Jung, F.^f | Prantl, L.^a

Affiliations: [a] Department of Plastic and Hand Surgery, University Hospital Regensburg, Germany | [b] Department of Anaesthesia, Pain Management and Perioperative Medicine, Faculty of Medicine, Dalhousie University, Halifax, Canada | [c] Central Institute for Biomedical Engineering, Department of Biomaterials, University of Ulm, Ulm, Germany | [d] Institute for Animal Hygiene, Animal Welfare and Farm Animal Behaviour and Virtual Center for Replacement - Complementary Methods to Animal Testing, University of Veterinary Medicine Hannover, Hannover, Germany | [e] Department of Anesthesiology, University Hospital Regensburg, Germany | [f] Institute of Biomaterial Science and Berlin-Brandenburg Centre for Regenerative Therapies, Helmholtz-Zentrum Geesthacht, Teltow, Germany

Correspondence: [*] Corresponding author: Dr. med. Philipp E. Lamby, Abteilung für Plastische, Hand und Wiederherstellungschirurgie, Universitätsklinikum Regensburg, Franz-Josef-Strauß-Allee 11, 93053 Regensburg, Germany. Tel.: +49 179 741 5929; E-mail: philipp.lamby@klinik.uni-regensburg.de.

Abstract: Repeated injections of iodinated contrast media (CM) can lead to a deterioration of the renal blood flow, can redistribute blood from the renal cortex to other parts of the kidney and can cause small decreases of the blood flow in cortical capillaries, a significant reduction in blood flow in peritubular capillaries and a significant reduction in blood flow in the vasa recta. Therefore, a study in pigs was designed, to show whether the repeated injection of CM boli, alone, can cause a reduction of oxygenation in the cortico-medullar renal tissue – the region with the highest oxygen demand in the kidney - of pigs. While the mean pO2-value had only decreased by 0.3 mmHg from 29.9±4.3 mmHg to 29.6±4.3 mmHg (p = 0.8799) after the tenth Iodixanol bolus, it decreased by 5.9 mmHg from 34.0±4.3 mmHg to 28.1±4.3 mmHg after the tenth Iopromide bolus (p = 0.044). This revealed a remarkable difference in the influence of these CM on the oxygen partial pressure in the kidney. Repeated applications of CM had a significant influence on the renal oxygen partial pressure. In line with earlier studies showing a redistribution of blood from the cortex to other renal areas, this study revealed that Iodixanol – in contrast to Iopromide - induced no changes in the pO2 in the cortico-medullar region which confirms that Iodixanol did not hinder the flow of blood through the renal micro-vessels. These results are in favor of a hypothesis from Brezis that a microcirculatory disorder might be the basis for the development of CI-AKI.

Keywords: Contrast agent, Iodixanol, Iopromide, tissue oxygen partial pressure, CI-AKI, contrast-induced acute kidney injury

DOI: 10.3233/CH-199009

Journal: Clinical Hemorheology and Microcirculation, vol. 73, no. 1, pp. 261-270, 2019