Pengaruh Media Kontras Iopamidol Dosis Tinggi Intravaskuler Terhadap Kadar Kreatinin Serum dan Gambaran Histopatologi Tubulus Ginjal pada Tikus Sprague-Dawley: Upaya Proteksi dengan L-arginin

Abstract

Dawley rats: using L-arginine as protection Background: Iopamidol, a Low Osmolar Contrast Media (LOCM), has relatively less nephrotoxicity, but contrast media (CM) volume has role to develop acute renal failure even in healthy person. L-arginine as a natural precursor of nitric oxide might prevent contrast nephropathy. Objectives: To investigate effects of iopamidol on acute renal damage by observing serum creatinine level and acute renal necrosis and to assses the role of L-arginine to protect acute renal failure. Methods: This was a post test only control group design experimental study using 35 male, twelve weeks old Sprague-Dawley rats, weighing 200-350 g, allocated into seven groups. The control group (K), P1, P2, P3 were group given 1.8 ml iopamidol and P4, P5, P6 groups were given 8.4% (W/V) L-arginine personde twice a day, 5 ml each for 7 days before 1.8 ml iopamidol injection. Serum creatinine and histological examination were done to assess acute tubular necrosis with H&E staining observed on 24, 48, and 72 hour accordingly. Dose of iopamidol used was equal to 100 ml human dose. The difference of serum creatinine and acute tubular necrosis were analyzed by using ANOVA test. Results: There were no significant differences among groups on serum creatinine level (p=0.261). Acute tubular necrosis increased following iopamidol administration in 72 hour (P3) p=0.007, and pretreatment with L-arginin reduced necrosis in group P6 (p=0.008). Conclusions: Serum creatinine level was not different after administration of iopamidol and L-arginine. Iopamidol induce acute tubular necrosis, while L-arginine can prevent CM-induced nephropathy.