Nephrotoxicity of Some Vasoactive Drugs Following Selective Intra-arterial Injection

Abstract

The nephrotoxicity of several drugs used in human pharmacoangiography has been studied by selective arterial injection in the rabbit kidney. The drugs used included epinephrine, 0.125 µg/kg to 16.0 µg/kg; vasopressin 0.06 IU/kg to 0.25 IU/kg; angiotensin 1.0 µg/kg to 2.0 µg/kg; and bradykinin 1.0 µg/kg to 8.0 µg/kg. The last 3 drugs showed no toxic changes at the levels studied. Pathological changes were seen in the rabbits studied following epinephrine at the 4.0 µg/kg level. If the epinephrine was followed by an injection of Urografin 76%, mild toxic lesions were seen at 0.5 µg/kg and 1.0 µg/kg. These changes appeared to be more severe if the contrast material was given 10 min after the epinephrine than if given 20 to 30 sec after epinephrine. The changes seen following epinephrine were those of anoxia and may have been due to transient intravascular clotting. The increased toxicity caused by delayed administration of contrast material suggests the possibility that epinephrine alters cellular permeability in some way. Regenerative changes were present in kidneys, which were studied one week after epinephrine injection.