Nan fang yi ke da xue xue bao = Journal of Southern Medical University · 2021
[Effect of half-dose fluorescein sodium contrast agent on liver and kidney functions in patients with mild to moderate chronic kidney disease: a retrospective cohort study].
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Li Y, Shi L, Jia L, Zhang H
Аннотация
OBJECTIVE: To observe the effect of half-dose fluorescein sodium (FINa) contrast agent on liver and kidney functions in patients with mild to moderate (stage 1 to 3) chronic kidney disease (CKD) and the incidence of contrast-induced nephropathy (CIN).
METHODS: Seventy-seven patients (including 50 male and 27 female patients with an mean age of 53.5±9.6 years) with CKD with normal renal function or mild to moderate abnormalities underwent fundus fluorescein angiography (FFG) examination with half-dose FINa. Liver function, blood creatinine (Scr), blood urea nitrogen (BUN), urine β2 microglobulin (β2-MG), and glomerular filtration rate (eGFR) of the patients were measured within 3 days before intravenous injection of the contrast agent and at 1, 3, 7, and 30±1 days after the operation to analyze the effect of the contrast agent on renal function.
RESULTS: Among the 77 patients, CIN occurred only in one case with an incidence rate of 1.30%. BUN, urine β2- MG, or rapid microalbumin/creatinine did not vary significantly after FFA in these patients. Scr levels showed no significant increments at 1 day and 7 days after FFA, but increased significantly at 3 days (24.6±2.3; P < 0.01) and 30 days (16.0±21.7; P < 0.05). Urine NAG enzymes and urinary osmolality were significantly reduced at 1, 3, 7, and 30 days after FFA (P < 0.01). The eGFR decreased significantly to 10.23±0.62 at 3 days after FAG and became normal at 7 days. Urine albumin level decreased significantly at 1, 3, 7, and 30 days after FFA (P < 0.01). Blood β2-MGFAG level increased significantly at 3 days after FFA (0.314± 0.121; P < 0.01), but decreased to 0.134±0.143 at 7 days (P < 0.05). The level transaminase decreased significantly at 3 and 7 days after FFA (P < 0.01).
CONCLUSION: Half-dose of FINa has no significant effect on liver function and has only minimal effect on kidney function in patients with mild to moderate CKD, and FFA with half-dose FINa can therefore be safely performed in these patients.
METHODS: Seventy-seven patients (including 50 male and 27 female patients with an mean age of 53.5±9.6 years) with CKD with normal renal function or mild to moderate abnormalities underwent fundus fluorescein angiography (FFG) examination with half-dose FINa. Liver function, blood creatinine (Scr), blood urea nitrogen (BUN), urine β2 microglobulin (β2-MG), and glomerular filtration rate (eGFR) of the patients were measured within 3 days before intravenous injection of the contrast agent and at 1, 3, 7, and 30±1 days after the operation to analyze the effect of the contrast agent on renal function.
RESULTS: Among the 77 patients, CIN occurred only in one case with an incidence rate of 1.30%. BUN, urine β2- MG, or rapid microalbumin/creatinine did not vary significantly after FFA in these patients. Scr levels showed no significant increments at 1 day and 7 days after FFA, but increased significantly at 3 days (24.6±2.3; P < 0.01) and 30 days (16.0±21.7; P < 0.05). Urine NAG enzymes and urinary osmolality were significantly reduced at 1, 3, 7, and 30 days after FFA (P < 0.01). The eGFR decreased significantly to 10.23±0.62 at 3 days after FAG and became normal at 7 days. Urine albumin level decreased significantly at 1, 3, 7, and 30 days after FFA (P < 0.01). Blood β2-MGFAG level increased significantly at 3 days after FFA (0.314± 0.121; P < 0.01), but decreased to 0.134±0.143 at 7 days (P < 0.05). The level transaminase decreased significantly at 3 and 7 days after FFA (P < 0.01).
CONCLUSION: Half-dose of FINa has no significant effect on liver function and has only minimal effect on kidney function in patients with mild to moderate CKD, and FFA with half-dose FINa can therefore be safely performed in these patients.