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 Function

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 w...

Full description

Saved in:
Bibliographic Details
Published in:Medical science monitor 2017-09, Vol.23, p.4299-4305
Main Authors: Spasojević-Dimitrijeva, Brankica, Kotur-Stevuljević, Jelena, Đukić, Milan, Paripović, Dušan, Miloševski-Lomić, Gordana, Spasojević-Kalimanovska, Vesna, Pavićević, Polina, Mitrović, Jadranka, Kostić, Mirjana
Format: Article
Language:English
Subjects:
Acute Kidney Injury - blood
Acute Kidney Injury - chemically induced
Acute Kidney Injury - urine
Adolescent
Biomarkers - blood
Biomarkers - urine
Case-Control Studies
Child
Child, Preschool
Clinical Research
Contrast Media - adverse effects
Creatinine - blood
Female
Gadolinium DTPA - adverse effects
Hepatitis A Virus Cellular Receptor 1 - metabolism
Humans
Iohexol - adverse effects
Iohexol - analogs & derivatives
Kidney - drug effects
Lipocalin-2 - blood
Male
Citations: Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary: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 AND 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 (baseline), 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.
ISSN:1643-3750
1234-1010
1643-3750
DOI:10.12659/MSM.903255