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Effect of iopentol on renal function and its use for calculation of glomerular filtration rate in children

G Stake1, T Monclair, K J Berg

  • 1Department of Paediatric Radiology, National Hospital, Oslo, Norway.

Acta Radiologica (Stockholm, Sweden : 1987)
|January 1, 1995
PubMed

Insights

Iopentol, used for pediatric urography, temporarily reduced glomerular filtration rate (GFR) by 12% in children. While tubular function showed minor changes, further research is needed before recommending iopentol as a GFR marker.

Area of Science:

  • Pediatric Nephrology
  • Radiology
  • Pharmacology

Background:

  • Glomerular filtration rate (GFR) is a key indicator of kidney function in children.
  • Accurate GFR measurement is crucial for diagnosing and managing pediatric kidney diseases.
  • Non-ionic contrast media are widely used in urography, but their effects on renal function require careful evaluation.

Purpose of the Study:

  • To investigate the impact of iopentol, a non-ionic contrast medium, on GFR in children undergoing urography.
  • To assess potential changes in renal tubular function following iopentol administration.
  • To evaluate iopentol's safety and diagnostic yield in pediatric urography.

Main Methods:

  • Nineteen children received 99mTc-DTPA for renography and subsequently iopentol for urography.
  • GFR was estimated using plasma elimination of both 99mTc-DTPA and iopentol.
  • Serum and urine biomarkers (creatinine, beta 2-microglobulin, alkaline phosphatase, N-acetyl-glucosaminidase, albumin) were analyzed.

Main Results:

  • Iopentol administration resulted in a significant GFR reduction of 12 +/- 3% without affecting serum creatinine or beta 2-microglobulin levels.
  • Urinary albumin and beta 2-microglobulin excretion remained unchanged.
  • Increased urinary excretion of alkaline phosphatase and N-acetyl-glucosaminidase indicated mild tubular effects.

Conclusions:

  • Iopentol caused transient GFR depression and mild tubular changes in children, presumed to be clinically insignificant.
  • The diagnostic yield of iopentol urography was high with few adverse events.
  • Further investigation is required to validate iopentol as a reliable GFR marker in pediatric patients.

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