Abstract
Oxidative stress is an important mechanism of contrast-induced acute kidney injury (CIAKI). The optimal strategy to prevent CIAKI remains unclear. The aim of the present study was to assess the effect of pentoxifylline, a nonspecific phosphodiesterase inhibitor, on the prevention of CIAKI. A total of 32 healthy male Sprague-Dawley rats were randomly divided into normal dietary group (NN; n=8) and a high cholesterol-supplemented dietary group (HN; 4% cholesterol and 1% cholic acid; n=24). At the end of eight weeks, the rats in the high cholesterol diet group were randomly divided into three subgroups (n=8 in each group). CIAKI was induced in two of the subgroups via intravenous injection of the radiocontrast media iohexol (10 ml/kg). Pentoxifylline (50 mg/kg) was administered to one of the iohexol-treated groups via intraperitoneal injection 12 h prior to and following contrast media (CM) injection. Kidney function parameters and oxidative stress markers were then measured. The renal pathological changes were evaluated using hematoxylin and eosin staining and scored semi-quantitatively. In iohexol-injected rats, serum creatinine (Scr), renal pathological scores, renal malondialdehyde (MDA) content, renal NADPH oxidase activity, fractional excretion of sodium (FENa%) and fractional excretion of potassium (FEK%) were significantly increased (P<0.01). The Scr, histologic scores, renal MDA content, NADPH oxidase activity, FENa% and FEK% in the rats treated with pentoxifylline prior to iohexol were observed to be reduced compared with those in rats treated with iohexol alone (P<0.01). This suggests that pentoxifylline significantly attenuates renal injuries, including tubular necrosis and proteinaceous casts induced by CM. It may be concluded that pentoxifylline protected the renal tissue from the nephrotoxicity induced by low-osmolar CM via an antioxidant effect.
Highlights
Contrast‐induced acute kidney injury (CIAKI) is a serious clinical complication, associated with increased use of iodinated contrast media (CM) in diagnostic and interventional procedures
Serum TG, CHOL, serum creatinine (Scr), creatinine clearance (Ccr), FENa% and FEK% values were analyzed in the four groups at baseline
In the rats treated with pentoxifylline and iohexol, the renal NADPH oxidase activity and MDA levels were significantly lower compared with those in the rats treated with iohexol alone (P
Summary
Contrast‐induced acute kidney injury (CIAKI) is a serious clinical complication, associated with increased use of iodinated contrast media (CM) in diagnostic and interventional procedures. It is the third most important cause of hospital‐acquired acute kidney injury and accounts for 12% of all cases [1]. We demonstrated that NADPH oxidase was a pivotal contributor to oxidative stress damage in CIAKI [6,7].
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