Impact of mannose-binding lectin deficiency on radiocontrast-induced renal dysfunction: a post-hoc analysis of a multicenter randomized controlled trial.

Abstract

BACKGROUND:

Local renal ischemia is regarded as an important factor in the development of contrast-induced nephropathy (CIN). Mannose-binding lectin (MBL) is involved in the tissue damage during experimental ischemia/reperfusion injury of the kidneys. The aim of the present study was to investigate the association of MBL deficiency with radiocontrast-induced renal dysfunction in a large prospective cohort.

METHODS:

246 patients with advanced non-dialysis-dependent renal dysfunction who underwent radiographic contrast procedures were included in the study. Baseline serum MBL levels were analyzed according to the occurrence of a creatinine-based (increase of ≥ 0.5 mg/dL or ≥ 25% within 48 hours) or cystatin C-based (increase of ≥ 10% within 24 hours) CIN.

RESULTS:

The incidence of creatinine-based and cystatin C-based CIN was 6.5% and 24%, respectively. MBL levels were not associated with the occurrence of creatinine-based CIN. However, patients that experienced a cystatin C increase of ≥ 10% showed significantly higher MBL levels than patients with a rise of <10% (median 2885 (IQR 1193-4471) vs. 1997 (IQR 439-3504)ng/mL, p = 0.01). In logistic regression analysis MBL deficiency (MBL levels ≤ 500 ng/ml) was identified as an inverse predictor of a cystatin C increase ≥ 10% (OR 0.34, 95% CI 0.15-0.8, p = 0.01).

CONCLUSION:

MBL deficiency was associated with a reduced radiocontrast-induced renal dysfunction as reflected by the course of cystatin C. Our findings support a possible role of MBL in the pathogenesis of CIN.

• Authors: Michael Osthoff, Vanja Piezzi, Theresia Klima, Andreas Christ, Ivana Marana, Sabine Hartwiger, Tobias Breidthardt, Giancarlo Marenzi, Marten Trendelenburg, Christian Mueller
• Journal: BMC nephrology (BMC Nephrol) Vol. 13 Pg. 99 (Sep 03 2012) ISSN: 1471-2369 [Electronic] England
• PMID: 22938690 (Publication Type: Journal Article, Multicenter Study, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)

Chemical References

• Biomarkers
• Contrast Media
• Cystatin C
• Iodine Compounds
• Mannose-Binding Lectin

Topics

• Acute Kidney Injury
• Aged
• Biomarkers (blood)
• Contrast Media
• Cystatin C (blood)
• Drug-Related Side Effects and Adverse Reactions (blood, epidemiology)
• Female
• Humans
• Iodine Compounds
• Male
• Mannose-Binding Lectin (blood)
• Prevalence
• Reproducibility of Results
• Risk Factors
• Sensitivity and Specificity
• Switzerland (epidemiology)