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November 2, 1984

Transient Glomerular Proteinuria, Enzymuria, and Nephrotoxic Reaction Induced by Radiocontrast Media

Author Affiliations

From the Clinical Pharmacology (Drs Nicot, Merle, Valette, Nouaille, and Lachâtre) and Nephrology (Drs Charmes and Leroux-Robert) Services, Dupuytren Hospital, Limoges, France.

JAMA. 1984;252(17):2432-2434. doi:10.1001/jama.1984.03350170034015

Contrast nephropathy is a recognized complication of arteriographic procedures; usually, it consists of a mild deterioration of renal function. In an attempt to understand better the mechanisms involved, we conducted a prospective study before and after arteriography that monitored the urinary elimination of high— and low—molecular weight proteins, the urinary activity of tubular enzymes, and renal clearances of 27 patients. We detected a noticeable and transient nonselective proteinuria of glomerular origin together with moderate signs of tubular damage and a stable renal function. We did not identify any risk factor. Contrast media may alter the disposition of charges along the glomerular filtering membrane in a way that promotes proteinuria; consequently, the massive flow of proteins may injure the tubular cells.

(JAMA 1984;252:2432-2434)