Proof of principle: hydration by low-osmolar mannitol-glucose solution alleviates undesirable renal effects of an iso-osmolar contrast medium in rats

Investigative Radiology
Erdmann SeeligerBert Flemming

Abstract

Saline infusion is widely used to prevent contrast media (CM)-induced acute kidney injury, because it fosters diuresis. Osmodiuretics have a stronger diuretic effect than saline, yet previous trials indicate that osmodiuretic mannitol tends to promote rather than to prevent CM-induced acute kidney injury. However, these studies used hypertonic mannitol solutions that will result in rebound volume contraction. We hypothesize that combining the osmodiuretic effects of a nonhypertonic mannitol solution with sustained volume expansion alleviates undesirable renal effects of CM. Forty-four anesthetized rats were studied by 4 protocols. Urine flow rate, urine viscosity, and glomerular filtration rate (GFR) were measured. Intravenous infusions of hydration solutions were initiated 60 minutes before CM administration and continued throughout the observation period. Hydration by a 3.2% mannitol and 3.2% glucose solution infused at 12 mL/kg per hour (Mannit-Gluc regimen) was compared with a standard regimen of isotonic saline at 4 mL/kg per hour (NaCl regimen); greater infusion rates are required for the Mannit-Gluc regimen because of the profound diuretic effect of mannitol. Two CM were studied: iso-osmolar iodixanol (320 mg I/mL) and l...Continue Reading

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Citations

Apr 8, 2014·BioMed Research International·Erdmann SeeligerPontus B Persson
May 7, 2014·BioMed Research International·Andreas M BucherRichard W Katzberg
Feb 1, 2017·Nature Reviews. Nephrology·Michael FählingPontus B Persson
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Aug 7, 2012·Investigative Radiology·Diana C LenhardGregor Jost
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Dec 16, 2016·BioMed Research International·Norbert Kiss, Péter Hamar
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