Biomarcadores de estrés oxidativo e inflamación en lesión renal aguda postcontraste yodado

  1. Elisabeth Stoll 1
  2. Pablo Monedero 1
  3. Paloma L. Martin-Moreno 1
  4. Nuria Garcia-Fernandez 1
  1. 1 Clínica Universidad de Navarra. Pamplona
Zeitschrift:
Anales del sistema sanitario de Navarra

ISSN: 1137-6627

Datum der Publikation: 2024

Ausgabe: 47

Nummer: 2

Seiten: 47-58

Art: Artikel

DOI: 10.23938/ASSN.1081 DIALNET GOOGLE SCHOLAR lock_openOpen Access editor

Andere Publikationen in: Anales del sistema sanitario de Navarra

Zusammenfassung

Fundamento. La lesión renal aguda postcontraste yodado (LRAPCY) es una causa frecuente de insuficiencia renal, especialmente en pacientes con factores de riesgo. Este estudio analiza diferentes biomarcadores renales en pacientes sometidos a tomografía computarizada con contraste yodado para identificar los mecanismos moleculares y celulares implicados en la patogénesis de la LRAPCY. Metodología. Estudio prospectivo de pacientes de alto riesgo renal que recibieron contraste yodado (iohexol) para tomografía computarizada. Se analizaron biomarcadores funcionales (creatinina y cistatina C), de inflamación y estrés oxidativo (lipocalina asociada a gelatinasa de neutrófilos [NGAL], interleucina-8 [IL-8], superóxido dismutasa [SOD], F2-isoprostanos y cardiotrofina-1) y de ciclo celular (Nephrocheck®), precontraste y 4, 12, 24 y 48 horas postcontraste, en relación con la LRAPCY. Resultados. Se observó LRAPCY en el 30,6% de los 62 pacientes incluidos y en el 57,1% de los pacientes con diabetes y disfunción renal. Los factores asociados con LRAPCY fueron: mayor edad media (74,4 vs 64,9 años), existencia de disfunción renal previa (60 vs 16,7%), y mayor volumen medio ajustado de iohexol (42,9 vs 32,1%). Los pacientes con y sin LRAPCY no difirieron respecto a los biomarcadores no-funcionales. Se observó una disminución de la actividad antioxidante de la SOD a las 4 horas y un aumento de IL-8 a las 12 horas post-administración del contraste yodado. Conclusiones. La administración de iohexol en tomografía computarizada en pacientes con alto riesgo de enfermedad renal resulta en un elevado porcentaje de LRAPCY, atribuible a daño por isquemia/reperfusión y/o toxicidad directa del contraste yodado.

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Fuente de los datos: Dialnet