Effect of Furosemide or Mannitol Before Injection of a Non-Ionic Contrast Medium on Intrarenal Oxygen Tension

Abstract

Haemodynamic factors may play a role in the development of acute renal failure following administration of contrast media (CM). Today, one of the main the theories for this complication is hypoxia in the renal medulla (Brezis and Rosen, 1995), usually associated with an earlier impairment of renal function. In a recent study we found that low-osmolar and iso-osmolar CM caused a decrease in oxygen tension (pO₂) in the inner strip of the outer medulla (Liss et al., 1998). Since pretreatment with diuretics has been suggested and is also used as a prophylactic measure against contrast medium-induced acute renal failure (CM-ARF) (Levinsky and Bernard, 1988; Better et al., 1997), this study was undertaken to ascertain whether pretreatment with furosemide or mannitol could prevent the decrease in oxygen tension in the outer medulla that follows injection of CM.