Improved estimation of glomerular filtration rate by serum cystatin C in preventing contrast induced nephropathy by N-acetylcysteine or zinc--preliminary results

Kimmel, Martin; Butscheid, Moritz; Brenner, Stefanie S.; Kuhlmann, Ulrich; Klotz, Ulrich; Alscher, Mark Dominik

doi:10.1093/ndt/gfm785

Cited by 42 publications

(26 citation statements)

References 34 publications

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“…A recent study reported that cystatine C [37] could be a better tool to assess the effect of contrast media on renal function than the currently used standard of serum creatinine level.…”

Section: Discussionmentioning

confidence: 99%

Frequency and predictors of contrast-induced nephropathy after angioplasty for chronic total occlusions

Aguiar-Souto

Ferrante

Furia

et al. 2010

International Journal of Cardiology

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“…A recent study reported that cystatine C [37] could be a better tool to assess the effect of contrast media on renal function than the currently used standard of serum creatinine level.…”

Section: Discussionmentioning

confidence: 99%

Frequency and predictors of contrast-induced nephropathy after angioplasty for chronic total occlusions

Aguiar-Souto

Ferrante

Furia

et al. 2010

International Journal of Cardiology

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“…Exclusion criteria were acute inflammatory disease, use of NSAID or metformin medication up to 3 days before the study, and abnormal findings in physical examination (e.g., signs of dehydration or inflammation). The detailed study protocol and population was as described by Kimmel et al [26]. Written informed consent was obtained from all patients.…”

Section: Methodsmentioning

confidence: 99%

Renal effects of metallothionein induction by zinc in vitro and in vivo

et al. 2017

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BackgroundMetallothionein (MTT) is an endogenous antioxidant that can be induced by both zinc (Zn) and ischemia. In kidneys, increased MTT expression exerts a putative protective role in diabetes and hypoxia. Our goal was to further investigate the behavior of MTT under the influence of Zn and hypoxia in vitro and in vivo.MethodsMTT expression was measured in vitro in cell cultures of proximal tubular cells (LCC-PK1) by immune-histochemistry and real-time PCR after incubation with increasing concentrations of Zn under hypoxic and non-hypoxic conditions. In addition, in vivo studies were carried out in 54 patients to study MTT induction through Zn. This is a sub-study of a prospective, randomized, double-blind trial on prevention of contrast-media-induced nephropathy using Placebo, Zn and N-Acetylcysteine. Blood samples were obtained before and after 2 days p.o. treatment with or without Zn (60 mg). ELISA-based MTT level measurements were done to evaluate the effects of Zn administration. For in vivo analysis, we considered the ratio of MTT to baseline MTT (MTT1/MTT0) and the ratio of eGFR (eGFR1/eGFR0), correspondingly.Results In vitro quantitative immuno-histochemical analysis (IHC) and real-time PCR showed that at increasing levels of Zn (5, 10, and 15 μg/ml) led to a progressive increase of MTTs: Median (IQR) expression of IHC also increased progressively from 0.10 (0.09–0.12), 0.15 (0.12–0.18), 0.25 (0.25–0.27), 0.59 (0.48–0.70) (p < 0.0001). Median (IQR) expression of PCR: 0.59 (0.51–1.72), 1.62 (1.38–4.70), 3.58 (3.06–10.42) and 10.81 (9.24–31.47) (p < 0.0001). In contrast, hypoxia did not change MTT-levels in vitro (p > 0.05). In vivo no significant differences (p = 0.96) occurred in MTT-levels after 2 days of Zn administration compared with no Zn intake. Nevertheless, there was a significant correlation between MTT (MTT1/MTT0) and eGFR (eGFR1/eGFR0) in case of Zn administration (rho = −0.49; 95%-CI: −0.78 to −0.03; p = 0.04).ConclusionsWe found that Zn did induce MTTs in vitro, whereas hypoxia had no significant impact. In contrast, no significant increase of MTTs was detected after in vivo administration of Zn. However, there was a significant negative correlation between MTT and eGFR in vivo in case of Zn administration, this could indicate a protective role of MTTs in a setting of reduced kidney function, which is possibly influenced by Zn.Trial registrationClinicalTrials.gov Identifier: NCT00399256. Retrospectively registered 11/13/2006.

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“…Cys has been proposed as an alternative to serum creatinine to evaluate GFR, owing to the absence of variations related to age, sex, and muscle mass (12,13 ). Furthermore, in some studies changes of Cys have enabled investigators to detect earlier changes of GFR than creatinine after administration of contrast media (14,15 ). A few studies have investigated the kinetics of Cys and serum creatinine variations in patients undergoing coronary angiography.…”

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confidence: 99%

Comparison of Serum Creatinine and Cystatin C for Early Diagnosis of Contrast-Induced Nephropathy after Coronary Angiography and Interventions

Ribichini

Gambaro

Graziani³

et al. 2012

Clinical Chemistry

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Improved estimation of glomerular filtration rate by serum cystatin C in preventing contrast induced nephropathy by N-acetylcysteine or zinc--preliminary results

Cited by 42 publications

References 34 publications

Frequency and predictors of contrast-induced nephropathy after angioplasty for chronic total occlusions

Frequency and predictors of contrast-induced nephropathy after angioplasty for chronic total occlusions

Renal effects of metallothionein induction by zinc in vitro and in vivo

Comparison of Serum Creatinine and Cystatin C for Early Diagnosis of Contrast-Induced Nephropathy after Coronary Angiography and Interventions

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