Radiology, Vol 195, 17-22, Copyright © 1995 by Radiological Society of North America
Nephrotoxicity from contrast media: attenuation with theophylline
RE Katholi, GJ Taylor, WP McCann, WT Woods Jr, KA Womack, CD McCoy, CR Katholi, HW Moses, GJ Mishkel and CL Lucore
Prairie Education Research Cooperative, Springfield, Ill.
PURPOSE: To determine if depression of creatinine clearance after
administration of contrast medium may be prevented with theophylline.
MATERIALS AND METHODS: A nonionic, low-osmolality contrast medium
(iopamidol) or an ionic, high-osmolality contrast medium (sodium
diatrizoate) was administered to 93 patients. Before the examination, these
patients were given theophylline or a placebo orally. There were also 30
patients who received an adenosine-uptake inhibitor (dipyridamole).
Creatinine clearance and urinary adenosine levels were measured before and
after angiography. RESULTS: Creatinine clearance decreased 18% +/- 4 in the
placebo-iopamidol group but did not decrease in the theophylline group;
urinary adenosine increased 67% +/- 7. Creatinine clearance decreased 42%
+/- 5 in the placebo-sodium diatrizoate group and decreased 24% +/- 3 in
the theophylline group; urinary adenosine increased 119% +/- 8. In the
dipyridamole group in which iopamidol was given, urinary adenosine
increased 96% +/- 7 and creatinine clearance decreased 37% +/- 5.
CONCLUSION: Intrarenal adenosine can be implicated in the pathogenesis of
hypertonic contrast medium nephrotoxicity.
