Serum Neutrophil Gelatinase-Associated Lipocalin and Urinary Kidney Injury Molecule-1 as Potential Biomarkers of Subclinical Nephrotoxicity After Gadolinium-Based and Iodinated-Based Contrast Media Exposure in Pediatric Patients with Normal Kidney Functio
| Autor: | Jadranka Mitrović, Milan Đukić, Dusan Paripovic, Brankica Spasojević-Dimitrijeva, Vesna Spasojevic-Kalimanovska, Polina Pavićević, Mirjana Kostic, Jelena Kotur-Stevuljevic, Gordana Milosevski-Lomic |
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| Rok vydání: | 2017 |
| Předmět: |
Gadolinium DTPA
Male medicine.medical_specialty Pathology Adolescent Iohexol Urinary system Urology Renal function Contrast Media Gadolinium Urine Kidney 030218 nuclear medicine & medical imaging Nephrotoxicity 03 medical and health sciences 0302 clinical medicine Lipocalin-2 Clinical Research 0502 economics and business medicine Humans Hepatitis A Virus Cellular Receptor 1 Child Subclinical infection medicine.diagnostic_test business.industry 05 social sciences Acute kidney injury Iopromide General Medicine Acute Kidney Injury medicine.disease 3. Good health Case-Control Studies Child Preschool Creatinine Angiography Female 050211 marketing business Biomarkers medicine.drug |
| Zdroj: | Medical Science Monitor Medical Science Monitor : International Medical Journal of Experimental and Clinical Research |
| Popis: | Background: New renal biomarkers such as neutrophil gelatinase-associated lipocalin (NGAL) and kidney injury molecule-1 (KIM-1) show promise in early diagnosis of contrast media induced acute kidney injury (CI-AKI). The purpose of our study was to compare the subclinical nephrotoxicity (a condition without changes in standard renal biomarkers) of gadolinium-based contrast media (Gd-DTPA, gadopentetate dimeglumine) and iodinated-based contrast media (iopromide) in pediatric patients with normal kidney function. Material/Methods: The first group (n=58) of patients included in the study were undergoing angiography with iopromide, and the second group (n=65) were undergoing magnetic resonance (MR) angiography/urography with Gd-DTPA administration. The concentrations of NGAL and KIM-1 were measured four times in the urine (pre-contrast, then at four hours, 24 hours, and 48 hours after contrast administration), and serum NGAL was measured at 0 (base-line), 24 hours, and 48 hours after contrast exposure. Results: After 24 hours, serum NGAL increase of >= 25% was noticed in 32.6% of the patients in the iopromide group and in 25.45% of the patients in the gadolinium group, with significantly higher average percent of this increase in first group (62.23% vs. 36.44%, p=0.002). In the Gd-DTPA group, we observed a statistically significant increase in urinary KIM-1 24 hours after the procedure. Normalized urinary KIM-1, 24 hours after contrast exposure, was a better predictive factor for CI-AKI than other biomarkers (AUC 0.757, cut off 214 pg/mg, sensitivity 83.3%, specificity 54.2%, p=0.035). Conclusions: In children with normal renal function, exposure to iodinated-based and gadolinium-based media might lead to subclinical nephrotoxicity, which could be detected using serum NGAL and urinary KIM-1. |
| Databáze: | OpenAIRE |
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