Urinary enzyme changes in children undergoing cineangiographic evaluation using iopromid

Area of Science:

• Nephrology
• Radiology
• Pediatric Medicine

Background:

• Radiocontrast media (RCM) can induce nephropathy, ranging from reversible dysfunction to dialysis-requiring oliguria.
• Assessing the renal safety of specific RCM, like iopromid, is crucial, especially in pediatric populations.

Purpose of the Study:

• To evaluate the potential nephrotoxic effects of iopromid in pediatric patients undergoing angiography.
• To determine if iopromid administration at maximum recommended doses (5 ml/kg) impacts renal function and tubular integrity.

Main Methods:

• A prospective study involving 19 pediatric patients (mean age 4.5 years).
• Measurements of plasma creatinine, creatinine clearance, plasma and urine osmolality, fractional sodium excretion, and urinary enzymes (AST, ALT, LDH, NAG) were taken before and 48 hours after angiography.
• Statistical analysis was performed to compare pre- and post-angiography values.

Main Results:

• No statistically significant changes were observed in plasma creatinine, creatinine clearance, plasma or urine osmolality, fractional sodium excretion, or plasma uric acid levels post-iopromid administration (p > 0.05).
• Urinary enzyme levels, including AST/creatinine, ALT/creatinine, LDH/creatinine, and NAG/creatinine, also showed no significant increase, indicating no substantial tubular injury.
• The observed changes in all measured renal function and urinary enzyme parameters were statistically insignificant.

Conclusions:

• Iopromid administration at a maximum dose of 5 ml/kg in pediatric patients does not appear to cause significant renal dysfunction.
• The study suggests that iopromid does not lead to tubular epithelium injury, as evidenced by stable urinary enzyme levels.
• These findings support the safety profile of iopromid in pediatric contrast-enhanced imaging procedures.