PREVENTION OF RENAL PROXIMAL TUBULAR CHANGES INDUCED BY RADIOCONTRAST MATERIAL WITH SODIUM BICARBONATE VERSUS SODIUM CHLORIDE INFUSION IN RATS: HISTOLOGICAL AND ULTRASTRUCTURAL STUDY
Hala F. Ahmad and Menna M. Abdel-Dayem
Histology Department, Faculty of Medicine, Cairo University
Radiocontrast induced nephropathy (RCIN) has been a significant cause of acute renal failure. This study aimed at evaluating proximal tubular structural and ultrastructural changes induced by contrast material (RCM) and to compare between the protective effects of isotonic sodium chloride and sodium bicarbonate infusion. This study included sixty adult male albino rats. They were anaesthetized and the tail veins were cannulated. The animals were divided into four groups: a control group, a group received RCM, a group received RCM+NaCl infusion and a group received RCM+NaHCO3 infusion. Serum creatinine levels were measured and animals were sacrificed at two, twenty-four and forty-eight hours. Kidneys were processed for light and electron microscopic studies. Serum creatinine was higher in group II and III at 2 hours and reached the control levels in all groups with advanced duration. At the light microscopic level, at two hours, the group received RCM demonstrated tubular damage, extensive vacuolization of the PCT cells and vascular congestion. With increasing the duration such changes were slightly reduced. Leukocytic infiltration was observed. Pre and post saline and sodium bicarbonate infusion reversed these changes and the last one was better. At the ultrastructural level, at early duration, the cytoplasm of PCT cells showed massive vacuolization, lysosomal and mitochondrial alterations. Disrupted apical microvilli and basal infoldings of the PCT cells could be observed. The changes became less with prolonged duration but did not exhibit complete recovery. Less vacuolization and accumulation of lysosomes in PCT cells could be observed after both sodium chloride and sodium bicarbonate infusion. The microvilli and the basal infoldings of PCT cells exhibited uniform arrangement. However, these changes were less with sodium bicarbonate than sodium chloride. Thus, it was concluded that RCM should be considered potentially toxic and hydration with isotonic sodium bicarbonate solution might provide a safe, simple and inexpensive method for preventing RCIN.