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

BMC Nephrology

Research Article

Ivana Marana¹  Giancarlo Marenzi¹  Christian Mueller²  Andreas Christ²  Theresia Klima³  Tobias Breidthardt³  Sabine Hartwiger⁴  Michael Osthoff⁵  Vanja Piezzi⁵  Marten Trendelenburg⁶ 

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

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

DOI  :  10.1186/1471-2369-13-99

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

来源: Springer

【 摘 要 】

BackgroundLocal 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.Methods246 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.ResultsThe 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).ConclusionMBL 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】

Unknown   
© Osthoff et al.; licensee BioMed Central Ltd. 2012. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.