Francesca Martino1,2, Gianpaolo Amici3, Ilaria Godi4, Michele Baretta4, Caterina Biasi4, Mariarosa Carta5, Valentina Corradi4, Massimo De Cal4, MaÍra Knust4, Claudia Tamayod4, Alessia Varotto6, Giuseppe Iannucci6, Davide Giavarina5, Sergio Savastano7, Claudio Ronco4,8. 1. International Renal Research Institute Vicenza, Vicenza, Italy. francesca.martino.k@gmail.com. 2. UO Nephrology, Dialysis and Kidney Transplant, San Bortolo Hospital, Vicenza, Italy. francesca.martino.k@gmail.com. 3. UO Nephrology and Dialysis, San Daniele del Friuli, and Tolmezzo Hospital, ASUFC, San Daniele del Friuli, Italy. 4. International Renal Research Institute Vicenza, Vicenza, Italy. 5. Department of Laboratory Medicine, San Bortolo Hospital, Vicenza, Italy. 6. Department of Neuroradiology, San Bortolo Hospital, Vicenza, Italy. 7. Department of Radiology, San Bortolo Hospital, Vicenza, Italy. 8. UO Nephrology, Dialysis and Kidney Transplant, San Bortolo Hospital, Vicenza, Italy.
Abstract
PURPOSE: We performed a pilot study to evaluate the feasibility of future research about the presence of subclinical kidney damage after Gadolinium-based contrast media exposure. The future study aims to understand which are the behaviors of two markers of kidney damage, such as urinary NephroCheck (NC) and/or neutrophil gelatinase-associated lipocalin (NGAL). Specifically, after GBCM exposure, NC urinary detection should identify proximal tubule damage while NGAL urinary detection should be related to distal tubule damage. METHODS: We performed a pilot study in patients who had Gadolinium exposure. The feasibility of future study is reached when at least 90% of candidates completed the pilot study. In each patient, we tested urinary NC and NGAL levels 24 h before magnetic resonance imaging (MRI) and 12-24 h after the exposure. Furthermore, we evaluated the administration of other nephrotoxic agents, the presence of comorbidity, and kidney function by S-creatinine and urine protein before the MRI. RESULTS: We enrolled 35 candidates of whom 33 patients completed all study procedures. Our population had a mean age of 60.7 ± 14.8 years with normal kidney function with a median S-creatinine equal to 0.7 mg/dl (Interquartile range [IQR] 0.6-0.91). Urinary NC levels increased from 0.21 ng2/ml2 (IQR 0.11-0.4) before MRI to 0.34 ng2/ml2 (IQR 0.16-0.86) (p = 0.005). Conversely, we did not appreciate any significant modification in urinary NGAL (p = 0.53). CONCLUSION: Our pilot study seems adequate in terms of feasibility and encourages us to focus our future research on renal proximal tubule, as the principal site of subclinical kidney damage after Gadolinium exposure.
PURPOSE: We performed a pilot study to evaluate the feasibility of future research about the presence of subclinical kidney damage after Gadolinium-based contrast media exposure. The future study aims to understand which are the behaviors of two markers of kidney damage, such as urinary NephroCheck (NC) and/or neutrophil gelatinase-associated lipocalin (NGAL). Specifically, after GBCM exposure, NC urinary detection should identify proximal tubule damage while NGAL urinary detection should be related to distal tubule damage. METHODS: We performed a pilot study in patients who had Gadolinium exposure. The feasibility of future study is reached when at least 90% of candidates completed the pilot study. In each patient, we tested urinary NC and NGAL levels 24 h before magnetic resonance imaging (MRI) and 12-24 h after the exposure. Furthermore, we evaluated the administration of other nephrotoxic agents, the presence of comorbidity, and kidney function by S-creatinine and urine protein before the MRI. RESULTS: We enrolled 35 candidates of whom 33 patients completed all study procedures. Our population had a mean age of 60.7 ± 14.8 years with normal kidney function with a median S-creatinine equal to 0.7 mg/dl (Interquartile range [IQR] 0.6-0.91). Urinary NC levels increased from 0.21 ng2/ml2 (IQR 0.11-0.4) before MRI to 0.34 ng2/ml2 (IQR 0.16-0.86) (p = 0.005). Conversely, we did not appreciate any significant modification in urinary NGAL (p = 0.53). CONCLUSION: Our pilot study seems adequate in terms of feasibility and encourages us to focus our future research on renal proximal tubule, as the principal site of subclinical kidney damage after Gadolinium exposure.
Authors: Ravindra L Mehta; Hamid Rabb; Andrew D Shaw; Kai Singbartl; Claudio Ronco; Peter A McCullough; John A Kellum Journal: Contrib Nephrol Date: 2013-05-13 Impact factor: 1.580
Authors: Christian Schmidt-Lauber; Lukas Bossaller; Hani H Abujudeh; Gregory I Vladimer; Anette Christ; Katherine A Fitzgerald; Eicke Latz; Ellen M Gravallese; Ann Marshak-Rothstein; Jonathan Kay Journal: Ann Rheum Dis Date: 2014-06-09 Impact factor: 19.103
Authors: Kianoush Kashani; Ali Al-Khafaji; Thomas Ardiles; Antonio Artigas; Sean M Bagshaw; Max Bell; Azra Bihorac; Robert Birkhahn; Cynthia M Cely; Lakhmir S Chawla; Danielle L Davison; Thorsten Feldkamp; Lui G Forni; Michelle Ng Gong; Kyle J Gunnerson; Michael Haase; James Hackett; Patrick M Honore; Eric A J Hoste; Olivier Joannes-Boyau; Michael Joannidis; Patrick Kim; Jay L Koyner; Daniel T Laskowitz; Matthew E Lissauer; Gernot Marx; Peter A McCullough; Scott Mullaney; Marlies Ostermann; Thomas Rimmelé; Nathan I Shapiro; Andrew D Shaw; Jing Shi; Amy M Sprague; Jean-Louis Vincent; Christophe Vinsonneau; Ludwig Wagner; Michael G Walker; R Gentry Wilkerson; Kai Zacharowski; John A Kellum Journal: Crit Care Date: 2013-02-06 Impact factor: 9.097