Lack of nephrotoxicity of gadopentetate dimeglumine-enhanced non-vascular MRI and MRI without contrast agent in patients at high-risk for acute kidney injury
Ebru Gok Oguz, Ahmet Kiykim, Kenan Turgutalp, Refik Olmaz, Onur Ozhan, Necati Muslu, Mehmet Horoz, Simge Bardak, Mehmet Ali Sungur
Department of Internal Medicine, Division of Nephrology, School of Medicine, Mersin University, Mersin, Turkey
Med Sci Monit 2013; 19:942-948
Gadolinium chelates (GCs) have been traditionally considered as non-nephrotoxic magnetic resonance imaging (MRI) contrast materials. However, it has been suggested in some recent articles that GCs may have a nephrotoxic potential, but most of these reports are retrospective. However, the evaluated contrast agents, their doses, and the tests used to determine the kidney function were not consistent across studies. We aimed to investigate the effect of magnetic field and an MRI contrast agent, gadopentetate dimeglumine (GD), on renal functions in patients at high risk for acute kidney injury (AKI).
Material and Methods: We designed a prospective case-control study with 2 age- and sex-matched groups of patients at high-risk for AKI (n=72 for each group). Patients in Group 1 received a fixed dose of (0.2 mmol/kg) GD-enhanced non-vascular MRI and patients in Group 2 received MRI without GD. Before the MRI and at 6, 24, 72, and 168 hours after the MRI, biochemical tests, estimated glomerular filtration rate (eGFR), albumin/creatinine ratio in spot urine, and early AKI biomarkers (cystatin C, N-Acetyl-Glucosaminidase [NAG], Neutrophil gelatinase-associated lipocalin [NGAL]) were measured.
Results: Serum creatinine, albumin/creatinine ratio, and eGFR were not different between Group 1 and 2 (p>0.05). There were no significant changes in renal function tests and AKI biomarkers (∆serum creatinine, ∆albumin/creatinine ratio, ∆GFR, ∆cystatin C, ∆NAG, and ∆NGAL) for either groups 6, 24, 72, and 168 hours after the procedures (p>0.05).
Conclusions: MRI without contrast agent and non-vascular contrast-enhanced (GD, 0.2 mmol/kg) MRI are not nephrotoxic procedures for patients at high risk for AKI.
Keywords: Acute Kidney Injury - diagnosis, Acetylglucosaminidase, Aged, 80 and over, Albuminuria, Case-Control Studies, Contrast Media - adverse effects, Creatinine - urine, cystatin C, Gadolinium DTPA - adverse effects, Glomerular Filtration Rate - drug effects, Kidney - drug effects, Magnetic Resonance Imaging - methods, Prospective Studies