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| 혈관조영술 전후의 혈중 및 뇨중microglobulin치의 변동 및 신부전에 관한 연구 |
| 이정상 ( 李正相 ) 안규리( 安圭里 ) , 한진석( 韓鎭錫 ) , 김성권( 金聖權 ) ,박재형( 朴在亨 ) 한만청 ( 韓萬靑 ) |
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| Abstract |
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Though the introduction of triiodinated contrast media has lowered the risk of renal impairment, the incidence of renal failure has been increased partly becauae of the more frequent use of contraat agents in radiologic studiea, and of the developm- ent of new techniques that use higher amount of the agent. The present study was undertaken firat, to ide- atify the true incidences an4 influences of study items, risk factors, and doses administered on co- ntrast mediated renal failure. 25l patients who took dye studies were reviewed retrospectively. Secondly, we meaaured markers of renal damage: beta2-microglobuhn, creatinine, osmolality, and sodium-serially to define the pattern of renal dam- age. In this pcospective project, 51 patients were included. The observed reaulta were as followed; 1) Acute renal failure defined as elevation of serum creatinine more than l. 0 mg/dl or decrem- ent of urina output to leas than 50pml/day was obaerved in 4p patients(15. 6%). 2) Patients who had angiography, who with g or more riak factors had higher incidence of acute renal failure(p<0. 05)., A dose relationship was also suggested. 3) The urinary beta2-microglobulin value reached to its maximum level at one day after the study, but the serum creatinine did at two daya after the etudy. 4) Those who had normal serum creatinine va- lues ehowed some elevation of serum and urinary beta2-microglobuln lekels. 5) Late elevation of Feβgm or urinaiy Beta2-mic- roglobulin/ereatine ratio in acute renal failure co- mpaired to normal suggested that the tubular da- mage plays a dominat role in day 6), thouth the changea of GFR may be more important in early days. As a conclusion, serial monotoring of proximal tubular function as well as GFR by urinary beta 2-microglobulin has potential value in asseesment of insert site. It was a more sensitivo index of renal functional impairment produced by contrast media. |
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