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Gadolinium-based contrast media exposure and the possible risk of subclinical kidney damage: a pilot study

  • Nephrology - Original Paper
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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.

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Acknowledgements

The authors wish to thank the physicians and nurses at the Neuroradiology and Radiology Department for their work. Without their support, this work would not have been possible.

Funding

The study did not receive any kind of funding.

Author information

Authors and Affiliations

  1. International Renal Research Institute Vicenza, Vicenza, Italy

    Francesca Martino, Ilaria Godi, Michele Baretta, Caterina Biasi, Valentina Corradi, Massimo De Cal, MaÍra Knust, Claudia Tamayod & Claudio Ronco

  2. UO Nephrology, Dialysis and Kidney Transplant, San Bortolo Hospital, Vicenza, Italy

    Francesca Martino & Claudio Ronco

  3. UO Nephrology and Dialysis, San Daniele del Friuli, and Tolmezzo Hospital, ASUFC, San Daniele del Friuli, Italy

    Gianpaolo Amici

  4. Department of Laboratory Medicine, San Bortolo Hospital, Vicenza, Italy

    Mariarosa Carta & Davide Giavarina

  5. Department of Neuroradiology, San Bortolo Hospital, Vicenza, Italy

    Alessia Varotto & Giuseppe Iannucci

  6. Department of Radiology, San Bortolo Hospital, Vicenza, Italy

    Sergio Savastano

Authors
  1. Francesca Martino
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  2. Gianpaolo Amici
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  3. Ilaria Godi
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  4. Michele Baretta
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  9. MaÍra Knust
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  13. Davide Giavarina
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  14. Sergio Savastano
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  15. Claudio Ronco
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Contributions

All the authors have read and approved the final manuscript. Specifically, the authors’ contributions are: guarantors of the integrity of the entire study, FKM and CR; study concepts/study design or data acquisition, all the authors; manuscript drafting or manuscript revision for important intellectual content, all the authors; literature research/statistical analysis/data analysis/interpretation, FKM and GA; manuscript editing, all the authors.

Corresponding author

Correspondence to Francesca Martino.

Ethics declarations

Conflict of interest

CR received compensation and consulted for Astute Medical, OCD, Asahi Medical, Baxter, and Toray Medical. All the other authors have no competing interests.

Ethical approval

The study was approved by the local institutional ethics committee (Resolution number 1449, 25 September 2019). The clinical investigation was conducted according to the principles expressed in the Declaration of Helsinki.

Consent to participate

All the enrolled patients signed informed consent.

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Martino, F., Amici, G., Godi, I. et al. Gadolinium-based contrast media exposure and the possible risk of subclinical kidney damage: a pilot study. Int Urol Nephrol 53, 1883–1889 (2021). https://doi.org/10.1007/s11255-020-02779-2

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  • DOI: https://doi.org/10.1007/s11255-020-02779-2

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