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Exacerbation of radiocontrast nephrotoxicity by endothelin receptor antagonism.

Publication ,  Journal Article
Wang, A; Holcslaw, T; Bashore, TM; Freed, MI; Miller, D; Rudnick, MR; Szerlip, H; Thames, MD; Davidson, CJ; Shusterman, N; Schwab, SJ
Published in: Kidney Int
April 2000

BACKGROUND: Endothelin is a potent vasoconstrictor that has been implicated in the pathogenesis of radiocontrast nephrotoxicity. Endothelin antagonists may reduce the renal hemodynamic abnormalities following radiocontrast administration. METHODS: One hundred fifty-eight patients with chronic renal insufficiency [mean serum creatinine +/- SD = 2.7 +/- 1.0 mg/dL (242. 3 to +/- 92.8 micromol/L)] and undergoing cardiac angiography were randomized to receive either a mixed endothelin A and B receptor antagonist, SB 290670, or placebo. All patients received intravenous hydration with 0.45% saline before and after radiocontrast administration. Serum creatinine concentrations were measured at baseline, 24 hours, 48 hours, and 3 to 5 days after radiocontrast administration. The primary end point was the mean change in serum creatinine concentration from baseline at 48 hours; the secondary end point was the incidence of radiocontrast nephrotoxicity, defined as an increase in serum creatinine of > or =0.5 mg/dL (44 micromol/L) or > or = 25% from baseline within 48 hours of radiocontrast administration. RESULTS: The mean increase in serum creatinine 48 hours after angiography was higher in the SB 209670 group [0.7 +/- 0. 7 mg/dL (63.5 +/- 58.6 micromol/L)] than in the placebo group [0.4 +/- 0.6 mg/dL (33.6 +/- 55.1 micromol/L), P = 0.002]. The incidence of radiocontrast nephrotoxicity was also higher in the SB 209670 group (56%) compared with placebo (29%, P = 0.002). This negative effect of SB 209670 was apparent in both diabetic and nondiabetic patients. Adverse effects, especially hypotension or decreased blood pressure, were more common in the SB 209670 group. CONCLUSIONS: In patients with chronic renal insufficiency who were undergoing cardiac angiography, endothelin receptor antagonism with SB 209670 and intravenous hydration exacerbate radiocontrast nephrotoxicity compared with hydration alone.

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Published In

Kidney Int

DOI

ISSN

0085-2538

Publication Date

April 2000

Volume

57

Issue

4

Start / End Page

1675 / 1680

Location

United States

Related Subject Headings

  • Urology & Nephrology
  • Time Factors
  • Sodium Chloride
  • Prospective Studies
  • Middle Aged
  • Male
  • Kidney Failure, Chronic
  • Kidney Diseases
  • Injections, Intravenous
  • Indans
 

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Chicago
ICMJE
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Wang, A., Holcslaw, T., Bashore, T. M., Freed, M. I., Miller, D., Rudnick, M. R., … Schwab, S. J. (2000). Exacerbation of radiocontrast nephrotoxicity by endothelin receptor antagonism. Kidney Int, 57(4), 1675–1680. https://doi.org/10.1046/j.1523-1755.2000.00012.x
Wang, A., T. Holcslaw, T. M. Bashore, M. I. Freed, D. Miller, M. R. Rudnick, H. Szerlip, et al. “Exacerbation of radiocontrast nephrotoxicity by endothelin receptor antagonism.Kidney Int 57, no. 4 (April 2000): 1675–80. https://doi.org/10.1046/j.1523-1755.2000.00012.x.
Wang A, Holcslaw T, Bashore TM, Freed MI, Miller D, Rudnick MR, et al. Exacerbation of radiocontrast nephrotoxicity by endothelin receptor antagonism. Kidney Int. 2000 Apr;57(4):1675–80.
Wang, A., et al. “Exacerbation of radiocontrast nephrotoxicity by endothelin receptor antagonism.Kidney Int, vol. 57, no. 4, Apr. 2000, pp. 1675–80. Pubmed, doi:10.1046/j.1523-1755.2000.00012.x.
Wang A, Holcslaw T, Bashore TM, Freed MI, Miller D, Rudnick MR, Szerlip H, Thames MD, Davidson CJ, Shusterman N, Schwab SJ. Exacerbation of radiocontrast nephrotoxicity by endothelin receptor antagonism. Kidney Int. 2000 Apr;57(4):1675–1680.
Journal cover image

Published In

Kidney Int

DOI

ISSN

0085-2538

Publication Date

April 2000

Volume

57

Issue

4

Start / End Page

1675 / 1680

Location

United States

Related Subject Headings

  • Urology & Nephrology
  • Time Factors
  • Sodium Chloride
  • Prospective Studies
  • Middle Aged
  • Male
  • Kidney Failure, Chronic
  • Kidney Diseases
  • Injections, Intravenous
  • Indans