Safety and Pharmacokinetic Profile of Gadobenate Dimeglumine in Subjects With Renal Impairment

Swan, Suzanne K.; Lambrecht, Lawrence J.; Townsend, Raymond R.; Davies, Brian E.; McCLOUD, Shirley; Parker, John R.; Bensel, Kathleen; LaFrance, Norman

doi:10.1097/00004424-199907000-00001

Cited by 91 publications

(54 citation statements)

References 6 publications

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“…As a result, elimination half-life, which is approximately 1.6 hours in normal individuals, is increased approximately 4-to 33-fold in renal failure, depending on the level of GFR. 16,17,20,21 This increases the potential for Gd 3þ dissociation through prolonged circulation times.…”

Section: What Is the Role Of Gbc In Nsf?mentioning

confidence: 99%

Nephrogenic systemic fibrosis: What the hospitalist needs to know

Fine

Perazella

2010

Journal of Hospital Medicine

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Nephrogenic systemic fibrosis (NSF) has now been linked to gadolinium‐based contrast (GBC) exposure in those with compromised kidney function, particularly those with end‐stage renal disease (ESRD). When ESRD is present, symptoms can be quite devastating for the patient including severe pain and immobility and even death. For those at risk, avoidance of GBC exposure, whenever possible, is absolutely essential to prevent this potentially devastating complication. Identifying those at risk depends in some circumstances on appropriate recognition of renal dysfunction and understanding appropriate use of glomerular filtration rate (GFR) estimation formulas. Although hemodialysis (but not peritoneal dialysis) removes gadolinium, the availability of dialysis should never be used as a justification for GBC use in this high‐risk population. Unfortunately there is a lack of a universally effective therapy. Resolution of acute kidney injury (AKI) appears to attenuate disease in most cases, while kidney transplantation has been associated with variable success. Journal of Hospital Medicine 2010;5:46–50. © 2010 Society of Hospital Medicine.

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Section: What Is the Role Of Gbc In Nsf?mentioning

confidence: 99%

Nephrogenic systemic fibrosis: What the hospitalist needs to know

Fine

Perazella

2010

Journal of Hospital Medicine

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“…The elimination half-life is increased in patients with renal insufficiency and may exceed 30 hours (29)(30)(31). Logically, it is inversely proportional to the residual renal function (26).…”

Section: Chemistry and Pharmacology Of Gadolinium Chelatesmentioning

confidence: 99%

Role of thermodynamic and kinetic parameters in gadolinium chelate stability

Idée

Port

Robic

et al. 2009

Magnetic Resonance Imaging

162

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In recent years there has been a renewed interest in the physicochemical properties of gadolinium chelates (GC). The aim of this review is to discuss the physicochemical properties of marketed GC with regard to possible biological consequences. GC can be classified according to three key molecular features: 1) the nature of the chelating moiety: either macrocyclic molecules in which Gd 3þ is caged in the preorganized cavity of the ligand, or linear, openchain molecules; 2) ionicity: the ionicity of the molecule varies from neutral to tri-anionic agents; and 3) the presence or absence of an aromatic lipophilic moiety, which has a profound impact on the biodistribution of the GC. These parameters can also explain why GC differ considerably with regard to their thermodynamic stability constants and kinetic stability, as demonstrated by numerous studies. The concept of thermodynamic and kinetic stability is critically discussed, as it remains somewhat controversial, especially in predicting the amount of free gadolinium that may result from decomplexation of chelates in physiologic or pathologic situations. This review examines the possibility that the high kinetic stability provided by the macrocyclic structure combined with a high thermodynamic stability (reinforced by ionicity for macrocyclic chelates) can minimize the amount of free Gd 3þ released in the body.

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“…Gd 3ϩ may act as a trigger for NSF in patients with kidney disease on the basis of its reduced clearance and possibly its chelate-binding characteristics. Gd 3ϩ contrast is eliminated almost entirely (97%) by the kidneys (13). Reduced renal function significantly increases the half-life of Gd 3ϩ from 1.96 h in healthy individuals to 5.61 and 9.18 h in stages 4 and 5 CKD, respectively (13).…”

mentioning

confidence: 99%

“…Gd 3ϩ contrast is eliminated almost entirely (97%) by the kidneys (13). Reduced renal function significantly increases the half-life of Gd 3ϩ from 1.96 h in healthy individuals to 5.61 and 9.18 h in stages 4 and 5 CKD, respectively (13). In patients who have ESRD and are on hemodialysis, Gd 3ϩ is substantially removed (Ͼ95%) only after three hemodialysis treatments (14) and is poorly removed by peritoneal dialysis (15).…”

mentioning

confidence: 99%

Nephrogenic Systemic Fibrosis, Kidney Disease, and Gadolinium

Perazella¹

2007

Clinical Journal of the American Society of Nephrology

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Safety and Pharmacokinetic Profile of Gadobenate Dimeglumine in Subjects With Renal Impairment

Cited by 91 publications

References 6 publications

Nephrogenic systemic fibrosis: What the hospitalist needs to know

Nephrogenic systemic fibrosis: What the hospitalist needs to know

Role of thermodynamic and kinetic parameters in gadolinium chelate stability

Nephrogenic Systemic Fibrosis, Kidney Disease, and Gadolinium

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