Kartamihardja A Adhipatria P, Nakajima Takahito, Kameo Satomi, Koyama Hiroshi, Tsushima Yoshito
From the *Department of Radiology Diagnostic and Nuclear Medicine, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan; †Department of Nuclear Medicine and Molecular Imaging, Universitas Padjajaran, Bandung, Indonesia; ‡Department of Public Health, Gunma University and §Gunma University Initiative for Advance Research (GIAR), Maebashi, Gunma, Japan.
Invest Radiol. 2016 Oct;51(10):655-60. doi: 10.1097/RLI.0000000000000295.
The aim of this study was to investigate the impact of impaired renal function on gadolinium (Gd) retention in various organs after Gd-based contrast agent injection.
After local animal care and review committee approval, 23 normal mice and 26 with renal failure were divided into 4 treatment groups (Gd-DTPA-BMA, 5 mmol/kg; Gd-DOTA, 5 mmol/kg; GdCl3, 0.02 mmol/kg; and saline, 250 μL). Each agent was intravenously administered on weekdays for 4 weeks. Samples were collected on days 3 (short-term) and 45 (long-term) after the last injection. Gadolinium concentrations were quantified by inductively coupled plasma-mass spectrometry.
Three mice with renal failure and 2 normal mice in the GdCl3 group and 1 mouse with renal failure in the Gd-DTPA-BMA group died. In the Gd-DTPA-BMA group, impaired renal function increased short-term Gd retention in the liver, bone, spleen, skin, and kidney (P < 0.01) but did not affect long-term Gd retention. Gd-DTPA-BMA showed higher Gd retention than Gd-DOTA. Although Gd retention in the Gd-DOTA group was generally low, impaired renal function increased only long-term hepatic Gd retention. Hepatic and splenic Gd retentions were significantly higher than other organs' Gd retention in the GdCl3 group (P < 0.01). Renal function did not affect brain Gd retention, regardless of the Gd compound used.
The tendency of Gd retention varied according to the agent, regardless of renal function. Although renal impairment increased short-term Gd retention after Gd-DTPA-BMA administration, long-term Gd retention for Gd-based contrast agents was almost unaffected by renal function, suggesting that the chemical structures of retained Gd may not be consistent and some Gd is slowly eliminated after initially being retained.
本研究旨在探讨肾功能受损对注射钆基造影剂后钆（Gd）在各器官中潴留的影响。
经当地动物护理和审查委员会批准后，将23只正常小鼠和26只肾衰竭小鼠分为4个治疗组（钆喷酸葡胺 - BMA，5 mmol/kg；钆喷替酸，5 mmol/kg；氯化钆，0.02 mmol/kg；生理盐水，250 μL）。在工作日静脉注射每种药物，持续4周。在最后一次注射后的第3天（短期）和第45天（长期）采集样本。通过电感耦合等离子体质谱法定量钆浓度。
氯化钆组中有3只肾衰竭小鼠和2只正常小鼠以及钆喷酸葡胺 - BMA组中有1只肾衰竭小鼠死亡。在钆喷酸葡胺 - BMA组中，肾功能受损增加了肝脏、骨骼、脾脏、皮肤和肾脏中的短期钆潴留（P < 0.01），但不影响长期钆潴留。钆喷酸葡胺 - BMA的钆潴留高于钆喷替酸。尽管钆喷替酸组中的钆潴留总体较低，但肾功能受损仅增加了长期肝脏钆潴留。在氯化钆组中，肝脏和脾脏中的钆潴留显著高于其他器官的钆潴留（P < 0.01）。无论使用何种钆化合物，肾功能均不影响脑钆潴留。
无论肾功能如何，钆潴留的趋势因药物而异。虽然肾功能损害在注射钆喷酸葡胺 - BMA后增加了短期钆潴留，但基于钆的造影剂的长期钆潴留几乎不受肾功能影响，这表明潴留的钆的化学结构可能不一致，并且一些钆在最初潴留后会缓慢消除。
