Abstract 2123: Gadolinium-DTPA-Exposure-Induced Systemic Inflammatory Response (GEISIR) in Patients with Chronic Renal Insufficiency

Background Cardiovascular morbidity is extraordinarily high in patients with chronic kidney disease (CKD) and accurate cardiovascular assessment is necessary. Due to the renal toxicity of certain contrast agents, this assessment has often been avoided. MRI contrast agents, such as gadolinium-DTPA, were originally thought to be a non-nephrotoxic alternative to iodinated contrast agents. The purpose of this study was to evaluate the safety of gadolinium-DTPA and to assess side effects in CKD patients who received gadolinium-DTPA during cardiovascular MRI. Methods Between August 2004 and December 2006, we longitudinally investigated 76 end-stage renal disease (ESRD) patients (70 haemodialysis=HD, 6 peritoneal dialysis=PD) who received gadolinium-DTPA during cardiovascular MRI. Results We report for the first time that 8% of ESRD patients experienced a gadolinium-DTPA-exposure-induced systemic inflammatory response (GEISIR). Furthermore, two of them previously not dialyzed CKD patients - rapidly progressed to end-stage renal failure. Conclusion Exposure to gadolinium-DTPA is not as harmless as was initially assumed. In ESRD patients, gadolinium-DTPA may induce severe adverse events, such as GEISIR. Therefore, short-term re-administration of gadolinium should be avoided in ESRD patients. Due to the extremely long half-life of gadolinium-DPTA, especially in PD patients, careful consideration should be given as to whether or not gadolinium-exposed patients require hemodialysis. Further data are imperative to determine optimal measures after gadolinium exposure in CKD patients

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End-Stage Renal Disease: A Slowly Progressive Systemic Inflammatory Response Syndrome

Contributions to Nephrology - Hemodialysis Technology ◽

10.1159/000060265 ◽

2002 ◽

pp. 379-385 ◽

Cited By ~ 3

Author(s):

C. Ronco ◽

N.W. Levin

Keyword(s):

Systemic Inflammatory Response Syndrome ◽

Inflammatory Response ◽

Renal Disease ◽

End Stage Renal Disease ◽

Systemic Inflammatory Response ◽

Stage Renal Disease ◽

End Stage

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Interleukin 6 (rs1800795) and Pentraxin 3 (rs2305619) Polymorphisms - Association with Inflammation and All-Cause Mortality in End-stage-renal Disease Patients on Dialysis

10.21203/rs.3.rs-378173/v1 ◽

2021 ◽

Author(s):

Susana Rocha ◽

Maria João Valente ◽

Susana Coimbra ◽

Cristina Catarino ◽

Petronila Rocha-Pereira ◽

...

Keyword(s):

Inflammatory Response ◽

Renal Disease ◽

Interleukin 6 ◽

End Stage Renal Disease ◽

Pentraxin 3 ◽

Allelic Frequencies ◽

All Cause Mortality ◽

Stage Renal Disease ◽

End Stage ◽

Esrd Patients

Abstract Chronic inflammation plays an important role in the progression and outcome of chronic kidney disease (CKD). The inflammatory biomarkers interleukin-6 (IL6) and pentraxin 3 (PTX3) are enhanced in CKD patients and associated with progression of the disease and higher risk for cardiovascular events, the major cause of death in these patients. Our aim was to study how the polymorphisms of their encoding genes affect the inflammatory response and outcome of end-stage renal disease (ESRD) patients on dialysis. We analyzed two single nucleotide polymorphisms (SNP), the IL6 (rs1800795) polymorphism in the promoter region (-174G/C), and the PTX3 polymorphism in the intron 1 (+ 281A/G), in ESRD patients on dialysis and in heathy individuals. The allelic frequencies, genotype distribution and their association with the circulating levels of the inflammatory markers high sensitivity C-reactive protein (hsCRP), interleukin (IL6), growth differentiation factor 15 (GDF15) and PTX3, were determined in ESRD patients; events of death were recorded along one year to evaluate all-cause mortality and the association between inflammation and the studied polymorphisms. The allelic frequencies and genotyping distribution for IL6 and PTX3 in controls and ESRD patients were similar and in agreement with European reports. For the IL6 polymorphism, we found an association of the GG and CC genotype with higher IL6 levels; the CC genotype showed also high PTX3, hsCRP and GDF15 levels. For the PTX3 polymorphism, the AA genotype was linked to the highest values of hsCRP and IL6. The mortality rate after 1-year follow-up was 10.4%. The CC genotype (IL6 polymorphism), in deceased patients, was associated to increased levels of hsCRP, IL6 and PTX3, with low levels of GDF15 and with a highest mortality risk. The AA genotype for PTX3 polymorphism, in spite of the enhancement in inflammation, showed no significant impact on mortality. Our results show that the CC genotype of the IL6 polymorphism was associated with an enhanced inflammatory state and a poorer survival rate. Both IL6 and PTX3 polymorphisms seem to modulate the inflammatory response and, therefore, disease progression and outcome. Our data also highlights the importance of research on genetic variants that, although less frequent, may have significant biological value.

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Analysis of the association between emergency dialysis start in patients with end-stage kidney disease and non-steroidal anti-inflammatory drugs, proton-pump inhibitors, and iodinated contrast agents

Journal of Nephrology ◽

10.1007/s40620-020-00952-5 ◽

2021 ◽

Author(s):

Aurélie Pétureau ◽

Maxime Raffray ◽

Elisabeth Polard ◽

Cécile Couchoud ◽

Cécile Vigneau ◽

...

Keyword(s):

Kidney Disease ◽

Contrast Agents ◽

Proton Pump Inhibitors ◽

Proton Pump ◽

End Stage Kidney Disease ◽

Iodinated Contrast ◽

Inflammatory Drugs ◽

Anti Inflammatory ◽

End Stage ◽

Iodinated Contrast Agents

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The systemic inflammatory response and its impact on iron nutriture in end-stage renal disease

American Journal of Kidney Diseases ◽

10.1053/ajkd.1999.v34.aajkd0344b0035 ◽

1999 ◽

Vol 34 (4) ◽

pp. s35-s39 ◽

Cited By ~ 11

Author(s):

Bruce R Bistrian ◽

Lalita Khaodhiar

Keyword(s):

Inflammatory Response ◽

Renal Disease ◽

End Stage Renal Disease ◽

Systemic Inflammatory Response ◽

Stage Renal Disease ◽

End Stage

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Interleukin 6 (rs1800795) and pentraxin 3 (rs2305619) polymorphisms-association with inflammation and all-cause mortality in end-stage-renal disease patients on dialysis

Scientific Reports ◽

10.1038/s41598-021-94075-x ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Susana Rocha ◽

Maria João Valente ◽

Susana Coimbra ◽

Cristina Catarino ◽

Petronila Rocha-Pereira ◽

...

Keyword(s):

Inflammatory Response ◽

End Stage Renal Disease ◽

Inflammatory Biomarkers ◽

Genotype Distribution ◽

Pentraxin 3 ◽

All Cause Mortality ◽

Stage Renal Disease ◽

End Stage ◽

Circulating Levels ◽

Esrd Patients

AbstractChronic inflammation plays an important role in the progression and outcome of chronic kidney disease (CKD). The circulating levels of the inflammatory biomarkers interleukin 6 (IL6) and pentraxin 3 (PTX3) are enhanced in CKD patients, and are associated with the progression of the disease and with higher risk for cardiovascular events, the major cause of death in CKD patients. Our aim was to study how specific polymorphisms of IL6 and PTX3 encoding genes affect the inflammatory response and outcome of end-stage renal disease (ESRD) patients on dialysis. Methodology included the analysis of two single nucleotide polymorphisms (SNP), namely the IL6 (rs1800795) polymorphism in the promoter region (-174G > C), and the PTX3 (rs2305619) polymorphism in the intron 1 (+ 281A > G), which were analyzed in ESRD patients on dialysis and in a group of heathy individuals. The allelic frequencies, genotype distribution and their association with circulating levels of the inflammatory markers C-reactive protein (CRP), IL6, growth differentiation factor 15 (GDF15) and PTX3, were determined in ESRD patients. Events of death were recorded along one year, to assess the association of the studied SNPs with all-cause mortality and the inflammatory biomarkers, in ESRD patients. Results showed that the allelic frequencies and genotype distribution for IL6 and PTX3 SNPs in the control group and ESRD patients were similar and in agreement with other European reports. For the IL6 polymorphism, we found a trend towards higher levels of high-sensitivity (hs) CRP, IL6 and PTX3 in the homozygous genotypes; the CC genotype also showed the highest levels of GDF15. The mortality rate after the 1-year follow-up was 10.4%. The CC genotype (IL6 SNP) was associated to a higher risk of mortality and deceased patients carrying this genotype also showed the highest levels of hsCRP. Regarding the studied PTX3 SNP, the AA genotype was linked to an enhanced inflammatory response, showing the highest values of hsCRP and IL6. Nevertheless, this genotype had no significant impact on the mortality rate. In conclusion, both studied SNPs seem to modulate the inflammatory response in ESRD and may, therefore, be determinant on disease progression and patients’ outcome. Our data also highlights the importance of research on genetic variants that, although less frequent, may have significant biological value.

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Model for end-stage liver disease score and systemic inflammatory response are major prognostic factors in patients with cirrhosis and acute functional renal failure

Hepatology ◽

10.1002/hep.21920 ◽

2007 ◽

Vol 46 (6) ◽

pp. 1872-1882 ◽

Cited By ~ 162

Author(s):

Dominique Thabut ◽

Julien Massard ◽

Alice Gangloff ◽

Nicolas Carbonell ◽

Claire Francoz ◽

...

Keyword(s):

Renal Failure ◽

Prognostic Factors ◽

Liver Disease ◽

Inflammatory Response ◽

Systemic Inflammatory Response ◽

Disease Score ◽

End Stage Liver Disease ◽

End Stage

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Direct CT Venography in ESRD Patients: Technical Experience and Findings

Siriraj Medical Journal ◽

10.33192/smj.2021.49 ◽

2021 ◽

Vol 73 (6) ◽

pp. 373-379

Author(s):

Sornsupha Limchareon ◽

Trakarn Chaivanit ◽

Suchanun Osatheerakul

Keyword(s):

Computed Tomography ◽

Internal Jugular Vein ◽

Jugular Vein ◽

Venous System ◽

Brachiocephalic Vein ◽

Common Site ◽

Iodinated Contrast ◽

Stage Renal Disease ◽

End Stage ◽

Esrd Patients

Objective: The aims of this study were to describe direct computed tomography venography (CTV) for upper limb venous system evaluation and to report on findings in end-stage renal disease (ESRD) patients.Materials and Methods: Direct CTV was performed using a 64-multidetector computed tomography (MDCT) scanner with simultaneous injection of diluted iodinated contrast (IC); 1:4 at both elbows and 2-phase scanning namely, the direct venous, and the arterial phases. The findings in ESRD patients evaluated between November 2013 and March 2019 were retrospectively reviewed.Results: Forty CTV examinations (600 venous segments) were performed and the volume of IC used per patient was 38 mL. Number of lesions found in a patient ranged from 1 to 6 and the majority had 1 to 3 lesions (30/38 patients). Stenosis and thrombosis were the two most common findings (112/600) and were equally prevalent. The three most common sites of steno-occlusive complications were the brachiocephalic vein (29 lesions), the internal jugular vein (25 lesions), and the subclavian vein (16 lesions). The most common site of stenosis was the brachiocephalic vein (18 lesions), whereas the most common site of thrombosis was the internal jugular vein (20 lesions). No venous aneurysms or ruptures were found. IC extravasation at the site of injection occurred in one arm in one patient.Conclusion: Direct CTV has the advantage of requiring lower IC volume while maintaining direct visualization of the venous system similar to conventional venography.

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