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

BMC Nephrology

Christian Mueller¹  Marten Trendelenburg¹  Giancarlo Marenzi³  Tobias Breidthardt⁵  Sabine Hartwiger²  Ivana Marana³  Andreas Christ¹  Theresia Klima⁵  Vanja Piezzi⁴  Michael Osthoff⁴ 

[1] Clinic for Internal Medicine, University Hospital Basel, Basel, Switzerland;Department of Anesthesiology, Kantonsspital Olten, Switzerland;Centro Cardiologico Monzino, Milan University, Milano, Italy;Laboratory of Clinical Immunology, Department of Biomedicine, University Hospital Basel, Basel, Switzerland;Department of Nephrology, University Hospital Basel, Basel, Switzerland

关键词: Acute kidney injury;    Ischemia/reperfusion injury;    Contrast-induced nephropathy;    Mannose-binding lectin;    Complement;   

Others  :  1083112
DOI  :  10.1186/1471-2369-13-99

 received in 2012-06-13, accepted in 2012-08-27,  发布年份 2012

【 摘 要 】

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.

【 授权许可】

   
2012 Osthoff et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

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