Role of adenosine in contrast media-induced acute renal failure in diabetes mellitus

Axel Pflueger, Timothy S. Larson, Karl A Nath, Bernard Francis King, Jennifer M. Gross, Franklyn G. Knox

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Abstract

Increased release of renal adenosine and stimulation of renal adenosine receptors have been proposed to be major mechanisms in the development of contrast media-induced acute renal failure (CM-ARF). Patients with diabetes mellitus or preexisting renal disease who have reduced renal function have a markedly increased risk to develop CM-ARF. This increased risk to develop CM-ARF in patients with diabetes mellitus is linked to a higher sensitivity of the renal vasculature to adenosine, since experimental studies have shown increased adenosine-induced vasoconstriction in the kidneys of diabetic animals. Furthermore, recent evidence suggests that administration of adenosine receptor antagonists reduces the risk of development of CM-ARF in both diabetic and nondiabetic patients. The purpose of this review is to discuss the role of adenosine in the development of CM-ARF, particularly in the kidneys of diabetic patients, and to evaluate the therapeutic potential of adenosine receptor antagonists in the prevention of CM-ARF. Selective adenosine A1 receptor antagonists may provide a therapeutic tool to prevent CM-ARF in patients with diabetes mellitus and reduced renal function.

Original languageEnglish (US)
Pages (from-to)1275-1283
Number of pages9
JournalMayo Clinic Proceedings
Volume75
Issue number12
StatePublished - 2000

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Acute Kidney Injury
Adenosine
Contrast Media
Diabetes Mellitus
Kidney
Purinergic P1 Receptor Antagonists
Adenosine A1 Receptor Antagonists
Preexisting Condition Coverage
Purinergic P1 Receptors
Vasoconstriction
Therapeutics

ASJC Scopus subject areas

  • Medicine(all)

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Role of adenosine in contrast media-induced acute renal failure in diabetes mellitus. / Pflueger, Axel; Larson, Timothy S.; Nath, Karl A; King, Bernard Francis; Gross, Jennifer M.; Knox, Franklyn G.

In: Mayo Clinic Proceedings, Vol. 75, No. 12, 2000, p. 1275-1283.

Research output: Contribution to journalArticle

Pflueger, A, Larson, TS, Nath, KA, King, BF, Gross, JM & Knox, FG 2000, 'Role of adenosine in contrast media-induced acute renal failure in diabetes mellitus', Mayo Clinic Proceedings, vol. 75, no. 12, pp. 1275-1283.
Pflueger, Axel ; Larson, Timothy S. ; Nath, Karl A ; King, Bernard Francis ; Gross, Jennifer M. ; Knox, Franklyn G. / Role of adenosine in contrast media-induced acute renal failure in diabetes mellitus. In: Mayo Clinic Proceedings. 2000 ; Vol. 75, No. 12. pp. 1275-1283.
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