Contrast-medium-induced acute renal failure and Tamm-Horsfall proteinuria

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Abstract
An acute obstructive nephropathy due to precipitation of urinary glycoprotein-contrast complexes in the renal tubules has been postulated to explain the episodes of [human] renal failure occasionally seen following intravascular contrast medium administration. In an in vitro study precipitation of contrast-glycoprotein complexes could not be produced over a wide range of concentrations, temperatures and pH values in urine with any urographic contrast agent, conventional or new. Meglumine ioglycamide (Biligram: Schering) alone, the strongly protein-binding agent, exhibited the phenomenon, and only in high concentration. Such a mechanism apparently is unlikely to play a role in contrast medium nephrotoxicity, which therefore remains unexplained.