The effect of karnitin in preventing contrast induced nephropathy

Title: The effect of karnitin in preventing contrast induced nephropathyAim and Hypothesis : Contrast induced nephropathy (CIN) is renal impairment occuring after the administriation of contrast materiels.There are many studies to prevent CIN but the results are not clear yet.The pathophysiology of CIN is not exactly understood . Suggested mechanisms are reduction in renal arter flow due to vasoconstruction , medullar hypoxy, direct tubular toxisity by apopitosis ,endotel disfunction and changes in renal microcirculation. We hypothesized in this study that L-carnitine prevents CIN.Method: Twenty-eight Wistar rats were included in the study and were divided into four groups. 24 hour urine was maintained using metabolic cages . Serum and 24 hour urine creatinin were measured and creatinin clirens was calculated. Rats were dehydrated for 24 hours in order to set off contrast nephropathy. No drugs were administirated to the first group (control group) , contrast agent (iohexol 10 ml/kg ) was given to second group , carnitine 500 mg/kg was given to third group , both carnitine and contrast agent were given to fourth group . In the fifth day blood samples were obtained to get creatinin levels . 24 hour urine was maintained by putting rats in metabolic cages for one day. After sacrification right kidney was exiced for histopathologic evaluation. Left kidney was exiced for measuring malondialdehyde (MDA) and total antioxidant status. Nephropathy was determined histopathologically. Contrast induced nephropathy (CIN) was defıned as an increase of 0,5 mg/dl or increase of %25 and more in serum creatinin over baseline .Results: No significant differances were found between serum creatinin, urine creatinin , creatinin clirens, TAC levels. MDA levels were statistically significant . Hystopatologic evaluation showed that carnitine when given with contrast agent prevents contrast induced nephropathy.Conclusion: Carnitine when given with contrast agent prevents contrast induced nephropathy . Several limitations should be noted. Our study includes a relatively small sample size. Relatively low-risk rats were included in our study. The effect of karnitin on high-risk rats should be investigated in larger prospective clinical studies.Keywords: Carnitine, contrast induced nephropathy, TAC, MDA, Hystopatologic evaluationCorrespondence: Adnan Menderes Üniversitesi Tıp Fakültesi Hastanesi Kardiyoloji Anabilim Dalı , Merkez/ Aydın , Tel:05059398612