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

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

Research output: Contribution to journalReview articlepeer-review

78 Scopus citations

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
DOIs
StatePublished - 2000

ASJC Scopus subject areas

  • Medicine(all)

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