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Los enfoques terapéuticos son muy limitados y existe un gran interés en avanzar en las estrategias preventivas. La adrenomedulina es un péptido relativamente nuevo con propiedades antioxidantes, vasoactivas y vasodilatadoras. Nuestro objetivo es investigar si la adrenomedulina puede jugar un papel preventivo frente al desarrollo de la NIC experimental. <span class="elsevierStyleBold">Métodos:</span> Se distribuyeron ratas Wistar albinas (n = 24) de forma aleatoria en cuatro grupos de 6: control (C), adrenomedulina (A), medio de contraste (MC) y adrenomedulina más medio de contraste (AMC). Las ratas no ingirieron agua desde el día 1 al día 4 (durante 72 horas). Posteriormente, se les administraron las sustancias de forma intravenosa. Los grupos A y AMC recibieron una dosis de adrenomedulina de 12 µg/kg. Los grupos MC y AMC recibieron una única dosis de medio de contraste de alta osmolaridad: 10 ml/kg de diatrizoato (Urografin 76 %, Schering AG, Alemania). Los días 1 y 6 se tomaron muestras de sangre para realizar análisis de función renal y de marcadores inflamatorios, incluidos el TNF-α, IL-1β, IL-6 e IL-18. Tras el sacrificio, se examinaron las histologías renales con tinción hematoxilina-eosina. <span class="elsevierStyleBold">Resultados:</span> En comparación con el grupo MC, los niveles de cistatina C sérica fueron significativamente inferiores en el grupo AMC (<span class="elsevierStyleItalic">P </span>< 0,05). Además, la tasa de excreción diaria de proteínas, los cambios absolutos en el gasto urinario diario y los valores de aclaramiento de la creatinina fueron significativamente inferiores en el grupo AMC que en el grupo MC (<span class="elsevierStyleItalic">P </span>< 0,05). En la evaluación histopatológica, en lo que respecta al grado de daño tubular y los valores de congestión medular, el grupo AMC presentaba niveles ligeramente mejores en comparación con el grupo MC. Sin embargo, según los marcadores inflamatorios, las diferencias no presentaron significación estadística. <span class="elsevierStyleBold">Conclusión:</span><span class="elsevierStyleBold"> </span>El estudio ha demostrado que la adrenomedulina resulta beneficiosa en los análisis de función renal deteriorada en un modelo experimental de NIC. Por lo tanto, la adrenomedulina puede ser un candidato para la profilaxis de la NIC. No obstante, se necesitan más estudios que arrojen luz sobre este tema.</p>" ] "en" => array:1 [ "resumen" => "<p class="elsevierStylePara"><span class="elsevierStyleBold">Background and aims:</span> Contrast-induced nephropathy (CIN) has a growing incidence in which renal vasoconstriction and medullary hypoxia are important mechanisms. Therapeutic approaches are very restricted and there is a considerable interest in advancing preventive strategies. Adrenomedullin is a relatively novel peptide having antioxidant, vasoactive and vasodilatory properties. We aimed to investigate whether adrenomedullin might have a preventive role against the development of experimental CIN. <span class="elsevierStyleBold">Methods:</span> Wistar albino rats (n=24) were allocated randomly into four equal groups of 6 each; Control (C), Adrenomedullin (A), Contrast Media (CM) and Adrenomedullin plus Contrast Media (ACM). All rats were deprived of water from day 1 to day 4 during 72 hours. Then, intravenous administrations of chemicals were performed. Adrenomedullin was given at dose of 12µg/kg to groups A and ACM. A single dose of high-osmolar contrast media; diatrizoate (Urografin 76%, Schering AG, Germany) was injected to groups CM and ACM at dose of 10mL/kg. On day 1 and 6 blood samples were drawn for renal function tests and inflammatory markers including TNF-α IL-1β, IL-6 and IL-18. After sacrification, kidney histologies were examined with hematoxylin-eosin staining. <span class="elsevierStyleBold">Results:</span> Compared to CM group, serum cystatin-C levels on 6<span class="elsevierStyleSup">th</span> day were found significantly lower in ACM group (p<0.05). Additionally, daily protein excretion rates, absolute changes in daily urine output and creatinine clearance values were significantly lower in ACM group than those in CM group (p<0.05). In histopathological evaluation, regarding the degree of tubular damage and medullary congestion scores, ACM group had slightly better scores compared to CM group; however the differences did not reach significance as shown in inflammatory markers. <span class="elsevierStyleBold">Conclusion:</span> This study demonstrated a beneficial impact of adrenomedullin on deteriorated renal function tests in an experimental CIN model. Adrenomedullin might be a candidate agent for prophylaxis of CIN. However, further studies are needed to shed more light on this issue.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "Bibliografía" "seccion" => array:1 [ 0 => array:1 [ "bibliografiaReferencia" => array:35 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Shiragami K, Fujii Z, Sakumura T, Shibuya M, Takahashi N, Yano M, et al. Effect of a contrast agent on long-term renal function and the efficacy of prophylactic hemodiafiltration. Circ J 2008;72:427-33. <a href="http://www.ncbi.nlm.nih.gov/pubmed/18296840" target="_blank">[Pubmed]</a>" "contribucion" => array:1 [ 0 => null ] "host" => array:1 [ 0 => null ] ] ] ] 1 => array:3 [ "identificador" => "bib2" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "McCullough PA, Soman SS. Contrast-induced nephropathy. 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Efecto protector de la adrenomedulina en la nefropatía inducida por contraste en ratas
Protective effect of adrenomedullin on contrast induced nephropathy in rats
Salih Inala, Eyüp Kocb, Gülay Ulusal-Okyayc, Özge T. Pasaoglud, Ipek Isik-Gönüle, Eser Öz-Oyarf, Hatice Pasaoglud, Galip Güza
a Department of Nephrology, Gazi University Faculty of Medicine, Ankara, Turkey,
b Department of Nephrology, Kirikkale University Faculty of Medicine, Kirikkale, Turkey,
c Department of Nephrology, Gazi University Faculty of Medicine, Ankara, Turkey,
d Department of Biochemistry, Gazi University Faculty of Medicine, Ankara, Turkey,
e Department of Pathology, Gazi University Faculty of Medicine, Ankara, Turkey,
f Department of Physiology, Gazi University Faculty of Medicine, Ankara, Turkey,
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Este artículo está disponible en español
Efecto protector de la adrenomedulina en la nefropatía inducida por contraste en ratas
Salih Inal, Eyüp Koc, Gülay Ulusal-Okyay, Özge T. Pasaoglu, Ipek Isik-Gönül, Eser Öz-Oyar, Hatice Pasaoglu, Galip Güz
10.3265/Nefrologia.pre2014.Sep.12405Nefrologia. 2014;34:724-31
This article is available in English
Protective effect of adrenomedullin on contrast induced nephropathy in rats
Salih Inal, Eyüp Koc, Gülay Ulusal-Okyay, Özge T. Pasaoglu, Ipek Isik-Gönül, Eser Öz-Oyar, Hatice Pasaoglu, Galip Güz
10.3265/Nefrologia.pre2014.Sep.12405Nefrologia (English Version). 2014;34:724-31