AKI - Clinical

Nephrology Dialysis Transplantation, May 2012

Introduction and Aims: Gadolinium chelate (GC)s using in magnetic resonance imaging (MRI) have been traditionally considered as non-nephrotoxic contrast materials. But, in some recent articles it has been suggested that GCs may have a nephrotoxic potential. Nevertheless, most of these reports are retrospective, and evaluated contrast agents and their doses were not homogenous. To investigate the effect of gadopentetate dimeglumine (GD) and magnetic field on renal function in patients with high-risk for acute kidney injury (AKI). Methods: We designed a prospective case control study, and age and sex-matched two groups of patients were included the study. Both of groups were consisted of the patients with high-risk for AKI (diabetes mellitus, hypotension, chronic renal failure, using nephrotoxic material, i.e.) (n=40, for each group). While contrast (gadopentetate dimeglumin)-enhanced non-vascular MRI was performed to group 1 patients, MRI without conrast agent was performed in goup 2 patients. Fixed dose of GD (0.2 mmol/kg) were administered to group 1 patients. All patients were followed up 72 hours. Before and at the 6, 24 and 72 hours after the MRI; biochemical markers, urinalysis, microalbumin/creatinine ratio in spot urine, serum creatinine, and glomerular filtration rate were measured. Results: Baseline serum creatinine, microalbumin/creatinine ratio, and GFR was not different between group 1 and group 2 (p>0.05). We did not observe adverse effect related to procedures. There were no significant changes in renal functional tests (?serum creatinine, ?microalbumin/creatinin ratio, and ?GFR) in both groups after 6, 24 or 72 hours of the procedures (p>0,05). Conclusions: Non-vascular contrast-enhanced (GD, 0.2 mmol/kg) MRI is a safe procedure for patients with high-risk for AKI. Key Words: MRI, Gadopentetate dimeglumine, contrast nephropathy, acute kidney injury.

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AKI - Clinical

Katharina Frster 2 7 10 14 15 19 24 29 31 34 37 41 44 47 55 56 59 66 70 75 Tim Kaufeld 2 7 10 14 15 19 24 29 31 34 37 41 44 47 55 56 59 66 70 75 Jan Kielstein 2 7 10 14 15 19 24 29 31 34 37 41 44 47 55 56 59 66 70 75 Tobias Schilling 2 7 10 14 15 19 24 29 31 34 37 41 44 47 55 56 59 66 70 75 Axel Haverich 2 7 10 14 15 19 24 29 31 34 37 41 44 47 55 56 59 66 70 75 Hermann Haller 2 7 10 14 15 19 24 29 31 34 37 41 44 47 55 56 59 66 70 75 Bernhard Schmidt 1 6 9 13 15 18 23 28 30 33 36 43 46 54 56 63 65 69 74 0 Ghent University Hospital - Nephrology - Gent - Belgium 1 Department of Nephrology & Hypertension, Medical School of Hannover , Germany 2 Hannover Medical School , Hannover, Germany 3 Division of Nephrology, Department of Internal Medicine, School of Medicine, Mersin University , Mersin, Turkey 4 Department of Bioistatistic, Shool of Medicine, Mersin University , Mersin, Turkey 5 Department of Biochemistry, Shool of Medicine, Mersin University , Mersin, Turkey 6 Ghent University Hospital 7 Ghent University Hospital , Ghent, Belgium 8 Central Laboratory, V. Fazzi Hospital , Lecce, Italy 9 Ospedale V Fazzi, Lecce, Italy 10 Nephrology, Dialysis, Transpl. Unit, V. Fazzi Hospital , Lecce, Italy 11 Istituto Superiore DI Sanit , Rome, Italy 12 2nd Department of Internal Medicine, "Amalia Fleming" General Hospital , Athens, Greece 13 1st Department of Internal Medicine, "Amalia Fleming" General Hospital , Athens, Greece 14 Nephrology Department, "Amalia Fleming" General Hospital , Athens, Greece 15 Vassilis Filiopoulos 16 Radiology Department, "Amalia Fleming" General Hospital , Athens, Greece 17 Division of Critical Care Nephrology, Department of Nephrology, Chang Gung Memorial Hospital 18 Department of Nephrology 19 Second Section of Cardiology 20 University of Colorado Health Sciences Center 21 University of Central Florida 22 San Bortolo Hospital 23 San Bassiano Hospital 24 Division of Nephrology, University of Padua , Padua, Italy 25 San Bortolo Hospital , Vicenza 26 Department of Nephrology , Dialysis and Transplant, St Bortolo Hospital, Irriv-International Renal Resarch Institute Vicenza , Vicenza, Italy 27 Department of Internal Medicine, Division of Nephrology, School of Medicine, Mersin University , Mersin, Turkey 28 Department of Biostatistic Schoo of Medicine , Mersin Universty 29 Mersin University Division of Nephrology, Department of Internal Medicine Mersin/Turkey 30 School of Medicine, University of Fortaleza , Fortaleza, Brazil 31 School of Medicine, Federal University of Ceara , Fortaleza, Brazil 32 Guy's & St Thomas Hospital, Department of Critical Care , London, United Kingdom 33 Epidemiology, University Hospital Center Nn Tereza 34 Nephrology, University Hospital Center Nn Tereza 35 Nephrology, Nagoya University Graduate School of Medicine , Nagoya, Aichi, Japan 36 Fujita Health University School of Medicine , Toyoake, Japan 37 Nephrology, Fujita Health University School of Medicine , Toyoake, Aichi, Japan 38 Nephrology, Fujita Health University School of Medicine , Toyoake, Aichi, Japa 39 Clinical Pathology and Immunology, Kobe University Graduate School of Medicine , Kobe, Hyogo, Japan 40 Respiratory and Allergic Medicine, Tosei General Hospital , Seto, Aichi, Japan 41 Department of Internal Medicine, College of Medicine, Yonsei University , Seoul, Korea 42 2first Critical Care Department National and Kapodistrian University of Athens , Greece , 43 1department of Nephrology, Aretaieion University Hospital , Athens, Greece 44 1department of Nephrology, Aretaieion University Hospital , Athens, Greece , 45 2first Critical Care Department National and Kapodistrian University of Athens , Greece 46 Iis-Fundacin Jimnez Daz, Autonoma University , Friat; Madrid, Spain 47 Hospital Universitario 12 de Octubre , Madrid, Spain 48 Iis-Fundacin Jimnez Daz, Autonoma University , Friat; Madrid, Spain 49 Complejo Hospitalario de Segovia , Segovia, Spain 50 Iis-Fundacin Jimnez Daz, Madrid, Spain 51 both Authors Contribute Equally To This Work 52 share Senior Authorship 53 Saarland University Hospital, Department of Internal Medicine 3 , Homburg/Saar, Germany 54 Saarland University Hospital, Department of Internal Medicine IV , Homburg/Saar, Germany 55 Saarland University Hospital, Department of Internal Medicine 4 , Homburg/ Saar, Germany 56 Lerner-Grber Anne-Kathrin 57 Saarland University Hospital, Department of Anesthesiology , Homburg/Saar, Germany 58 Saarland University Hospital, Department of Cardiothoracic Surgery , Homburg/Saar, Germany 59 Department of Pathology and Legal Medicine, Federal University of Ceara , Fortaleza, Brazil 60 Department of Physiology and Pharmacology, Federal University of Ceara , Fortaleza, Brazil 61 Department of Clinical Analysis and Toxicology, Federal University of Ceara , Fortaleza, Brazil 62 Center for Toxicological Assistance, Instituto Dr. Jos Frota , Fortaleza, Brazil 63 Hospital Geral Waldemar de Alcntara , Fortaleza, Brazil 64 Charles University, 1st Medical Faculty , Prague, Czech Republic 65 Charles University, 3rd Medical Faculty , Prague, Czech Republic 66 Thomayer Hospital , Prague, Department of Biochemistry 67 Institute of Clinical and Experimental Medicine , Prague, Czech Republic 68 Bremerhaven Hospital Reinkenheide 69 Medical School Hannover 70 Universital Hospital Schleswig-Holstein 71 Asklepios Hospital Hamburg Barmbek 72 Hospital Hannover Oststadt 73 Institute for Clinical Pharmacology, Otto-von-Guericke University , Magdeburg, Germany 74 Medical School of Hannover 75 Department of Nephrology and Hypertension Medical School Hannover , Hannover, Germany IS THE CONTRAST-ENHANCED MAGNETIC RESONANCE IMAGING OR MAGNETIC FIELD SAFE FOR THE PATIENTS WITH HIGH-RISK FOR ACUTE KIDNEY INJURY? References1 Conlon PJ et al.Nephrol Dial transplant 14(1999), 1158-1162.2 Stafford-Smith M et al. Am J of Kidney Disease 45(2005), 519-530. - Introduction and Aims: Gadolinium chelate (GC)s using in magnetic resonance imaging (MRI) have been traditionally considered as non-nephrotoxic contrast materials. But, in some recent articles it has been suggested that GCs may have a nephrotoxic potential. Nevertheless, most of these reports are retrospective, and evaluated contrast agents and their doses were not homogenous. To investigate the effect of gadopentetate dimeglumine (GD) and magnetic field on renal function in patients with high-risk for acute kidney injury (AKI). Methods: We designed a prospective case control study, and age and sex-matched two groups of patients were included the study. Both of groups were consisted of the patients with high-risk for AKI (diabetes mellitus, hypotension, chronic renal failure, using nephrotoxic material, i.e.) (n=40, for each group). While contrast (gadopentetate dimeglumin)-enhanced non-vascular MRI was performed to group 1 patients, MRI without conrast agent was performed in goup 2 patients. Fixed dose of GD (0.2 mmol/kg) were administered to group 1 patients. All patients were followed up 72 ho (...truncated)


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