Review article

The molecular mechanism of contrast-induced nephropathy (CIN) and its link to in vitro studies on iodinated contrast media (CM)

¹ Department of Medical Research, China Medical University Hospital, China Medical University, Taichung 404, Taiwan
² School of Medicine, China Medical University, Taichung 404, Taiwan
³ Department of Biological Science and Technology, China Medical University, Taichung 404, Taiwan
⁴ Department of Medical Imaging, Chung Shan Medical University Hospital, Taichung 402, Taiwan
⁵ School of Medical Imaging and Radiological Sciences, Chung Shan Medical University, Taichung 402, Taiwan
⁶ School of Medicine, Chung Shan Medical University, Taichung 402, Taiwan
⁷ Department of Pharmacy, Buddhist Tzu Chi General Hospital, Hualien 970, Taiwan
⁸ Division of Reconstructive and Plastic Surgery, Department of Surgery, Taipei Veterans General Hospital, Taipei 112, Taiwan
⁹ Chinese Medicinal Research and Development Center, China Medical University Hospital, China Medical University, Taichung 404, Taiwan
¹⁰ School of Pharmacy, China Medical University, Taichung 404, Taiwan
¹¹ Department of Diagnostic Radiology, Shin-Kong Wu Ho-Su Memorial Hospital, Taipei 111, Taiwan
¹² School of Medicine, Fu-Jen Catholic University, Taipei 242, Taiwan
¹³ Department of Medical Imaging, Chia-Yi Christian Hospital, Chiayi 600, Taiwan
¹⁴ Genetics Center, Department of Medical Research, China Medical University Hospital, Taichung 404, Taiwan
¹⁵ School of Chinese Medicine, China Medical University, Taichung 404, Taiwan
¹⁶ Department of Medical Genetics, China Medical University Hospital, Taichung 404, Taiwan

^* Corresponding author. Department of Medical Research, China Medical University Hospital, China Medical University, No. 2, YuhDer Road, Taichung 404, Taiwan. E-mail address: d0704@mail.cmuh.org.tw (F.-J. Tsai).

Received: 30 October 2017
Accepted: 7 November 2017

Abstract

Iodinated contrast media (iodinated CM) have increased ability to absorb x-rays and to visualize structures that normally are impossible to observe in a radiological examination. The use of iodinated CM may destory renal function, commonly known as contrast-induced nephropathy (CIN), which can result in acute renal failure (ARF). This review article mainly focuses on the following areas: (1) classifications of iodinated CM: ionic or non-ionic, high-osmolarity contrast media (HOCM), low-osmolarity contrast media (LOCM) and iso-osmolarity contrast media (IOCM); (2) an introduction to the physical and chemical properties of the non-ionic iodinated CM; (3) the management of anaphylactic reaction by iodinated CM; (4) a suggested single injection of adult doses and maximum dose for non-ionic iodinated CM; (5) the molecular mechanism of contrast-induced nephropathy (CIN); (6) In vitro studies on iodinated CM. Based on above information, this review article provide an insight for understanding the drug safety of iodinated CM.