Опубликовать статью

Информационное партнерство

Инфоресурсы

Контакты

«

Vol. 23, Art. 24 (pp. 369-384)    |    2022       

»

Experimental substantiation of the use of glutathione metabolism indicators in laboratory diagnostics of the risk of developing contrast-induced nephropathy against the background of diabetes mellitus

S.N. Zheregelya1, S.I. Glushkov,2, A.I. Karpishchenko2

St. Petersburg State Pediatric Medical University
Pavlov First Saint Petersburg State Medical University

Brief summary

Background. The overall risk of developing contrast-induced nephropathy during a study using contrast does not exceed 2%, but increases to 20-40% in patients with diabetes mellitus, congestive heart failure, chronic kidney disease and the elderly. In addition, the occurrence of contrast-induced nephropathy after cardiac catheterization procedures is associated with hospital mortality of up to 20% and mortality within a year of up to 66% and higher in patients who required dialysis. Objective.To determine the contribution of changes in glutathione metabolism to the mechanisms of formation of contrast-induced nephropathy to optimize measures for their prevention, diagnosis and treatment. Materials and methods. In a study conducted on 200 white mongrel male rats, the dynamics of changes in the concentration of reduced glutathione, malondialdehyde, as well as the activity of antioxidant defense enzymes (glucose-6-phosphate dehydrogenase, glutathione peroxidase, glutathione reductase and catalase) in kidney tissues and in erythrocytes of laboratory animals under the conditions of intoxication with an X-ray contrast preparation against the background of experimental (alloxane) diabetes mellitus were determined. Results. The triggering pathogenetic factor in the development of contrast-induced nephropathy is the summation of the depressing effects of diabetes mellitus and radiopaque drugs on the activity of glucose-6-phosphate dehydrogenase and glutathione reductase in kidney tissues, leading to a decrease in the concentration of reduced glutathione and violations of thiol-disulfide equilibrium. The consequence of this may be a decrease in the activity of thiol-dependent enzymes, and then a violation of a number of cellular functions. Disorders of glutathione metabolism are detected even against the background of maintaining the concentration of standard indicators for assessing kidney function (urea and creatinine in blood serum) at the level of intact control. All this indicates that the study of the state of the glutathione system (primarily, the activity of glucose-6-phosphate dehydrogenase and glutathione reductase) in blood cells are highly sensitive methods. Conclusion. Violations of glucose-6-phosphate dehydrogenase and glutathione reductase activity in kidney tissues can be considered as a trigger pathogenetic factor in the realization of nephrotoxic effects of radiopaque drugs. Determination of glucose-6-phosphate dehydrogenase and glutathione reductase activity in erythrocytes is a promising, highly sensitive, pathogenetically based laboratory method for assessing the risk and severity of contrast-induced nephropathy.


Key words

Contrast-induced nephropathy, glucose-6-phosphate dehydrogenase, glutathione reductase, alloxan diabetes mellitus, glutathione, radiopaque drugs.

Reference list

1. Cai Q., Jing R., Zhang W., Tang Y., Li X., Liu T. Hydration Strategies for Preventing Contrast-Induced Acute Kidney Injury: A Systematic Review and Bayesian Network Meta-Analysis // J Interv Cardiol. - 2020. - P. 1-16. doi:10.1155/2020/7292675.


2. Nijssen E., Rennenberg R., Nelemans P. et al. Prophylactic hydration to protect renal function from intravascular iodinated contrast material in patients at high risk of contrast-induced nephropathy (AMACING): a prospective, randomised, phase 3, controlled, open-label, non-inferiority trial //The Lancet. - 2017. - Vol. 389(10076). - P.1312-1322. doi:10.1016/s0140-6736(17)30057-0.


3. Chalikias G., Drosos I., Tziakas D. Contrast-Induced Acute Kidney Injury: An Update // Cardiovasc Drugs Ther. - 2016. - Vol. 30(2). - P.215-228. doi:10.1007/s10557-015-6635-0.


4. Haq M., Yip C., Arora P. The conundrum of contrast-induced acute kidney injury // J Thorac Dis. - 2020. - Vol. 12(4). - P.1721-1727. doi:10.21037/jtd.2019.12.88.


5. Lameire N., Kellum J. Contrast-induced acute kidney injury and renal support for acute kidney injury: a KDIGO summary (Part 2) // Critical Care. - 2013. - Vol. 17(1). - P.205. doi:10.1186/cc11455.


6. Mehran R., Dangas G., Weisbord S. Contrast-Associated Acute Kidney Injury //New England Journal of Medicine. - 2019. - Vol. 380(22). - P.2146-2155. doi:10.1056/nejmra1805256.


7. Romano G., Briguori C., Quintavalle C. et al. Contrast agents and renal cell apoptosis // Eur Heart J. - 2008. - Vol. 29(20). - P.2569-2576. doi:10.1093/eurheartj/ehn197.


8. Toprak O., Cirit M., Yesil M. et al. Metabolic Syndrome as a Risk Factor for Contrast-Induced Nephropathy in Non-Diabetic Elderly Patients with Renal Impairment // Kidney and Blood Pressure Research. - 2006. - Vol. 29(1). - P.2-9. doi:10.1159/000092481.


9. Diaz-Ricart M., Torramade-Moix S., Pascual G. et al. Endothelial Damage, Inflammation and Immunity in Chronic Kidney Disease // Toxins (Basel). - 2020. - Vol. 12(6). - P.361. doi:10.3390/toxins12060361.


10. Isaka Y., Hayashi H., Aonuma K. et al. Guideline on the use of iodinated contrast media in patients with kidney disease 2018 // Clin Exp Nephrol. - 2019. - Vol. 24(1). - P.1-44. doi:10.1007/s10157-019-01750-5.


11. Raptanova V.A., Speranskaya A.A., Proshin S.N. Kontrast-indycirovannie nefropatii (farmakologiya rentgenokontrastnih sredstv) // Pediatr. - 2016. - T. 7. 1. - S. 97-105.


12. Romano G., Briguori C., Quintavalle C . et al. Contrast agents and renal cell apoptosis // Eur Heart J. - 2008. - Vol. 29(20). - P.2569-2576. doi:10.1093/eurheartj/ehn197.


13. Jeregelya S.N., Glyshkov S.I., Karpishenko A.I. Izmeneniya pokazatelei sistemi glytationa v eritrocitah cheloveka pri vvedenii rentgenokontrastnih preparatov v diagnosticheskih dozah // Children's Medicine of the North-West. - 2021. - T. 9., 1. - S. 146-147.


14. Kusirisin P., Chattipakorn S., Chattipakorn N. Contrast-induced nephropathy and oxidative stress: mechanistic insights for better interventional approaches // J Transl Med. - 2020. - Vol. 18(1). doi:10.1186/s12967-020-02574-8.


15. Medicinskie laboratornie tehnologii: Rykovodstvo po klinicheskoi laboratornoi diagnostike: v 2-h t. / pod red. A.I. Karpishenko. - 3-e izd., pererab. i dop. - M.: GEOTAR-Media, 2012. - T. 1. - 792 s.


16. Medicinskie laboratornie tehnologii: rykovodstvo po klinicheskoi laboratornoi diagnostike: v 2-h t. / pod red. A.I. Karpishenko. - 3-e izd., pererab. i dop. - M.: GEOTAR-Media, 2013. - T. 2. - 472 s.


17. Sylvester R. WHO handbook for reporting results of cancer treatment // Control Clin Trials. - 1980. - Vol. 1(3). - P.276-277. doi:10.1016/0197-2456(80)90009-4.


18. Stincone A., Prigione A., Cramer T. et al. The return of metabolism: biochemistry and physiology of the pentose phosphate pathway // Biological Reviews. - 2014. - Vol. 90(3). - P.927-963. doi:10.1111/brv.12140.


19. Lautin E, Freeman N, Schoenfeld A et al. Radiocontrast-associated renal dysfunction: incidence and risk factors // American Journal of Roentgenology. - 1991. - Vol. 157(1). - P.49-58. doi:10.2214/ajr.157.1.2048539.


20. Kashyro V.A., Karpishenko A.I., Kycenko S.A., Glyshkov S.I. Vozmojnost ispolzovaniya opredeleniya pokazatelei sistemi glytationa v laboratornoi diagnostike oslojnenii kyrsovogo lecheniya ciklofosfanom // Klinicheskaya laboratornaya diagnostika. - 2002. - 10. - S. 43.


21. Glyshkov S.I., Novikova T.M., Aksenov V.V. Opredelenie pokazatelei sostoyaniya sistemi glytationa v eritrocitah kak diagnosticheskii priem ocenki riska formirovaniya doksorybicinovoi kardiomiopatii // Bulleten Federalnogo Centra serdca, krovi i endokrinologii im. V.A. Almazova. - 2004. - T. 2., 1. - S. 196.


22. Kashyro V.A. Patogeneticheskoe i diagnosticheskoe znachenie sistemi glytationa v ocenke citotoksicheskogo deistviya protivoopyholevih preparatov: avtoref. dis. d-ra med. nayk. - SPb., 2009. - 45 s.


23. Kashyro V.A., Dolgo-Sabyrov V.B., Dagaev S.G., Batocirenova E.G., Kybarskaya L.G., Aksenov V.V. Izychenie roli antioksidantnoi sistemi i perekisnogo okisleniya lipidov v patogeneze tiopentalovoi komi // Himicheskaya i biologicheskaya bezopasnost. - 2012. - S. - S. 3-7.

Журнал основан 16 ноября 2000г.
Выдано Министерством РФ по делам печати, телерадиовещания и средств массовых коммуникаций

(c) Перепечатка материалов сайта Medline.Ru возможна только с письменного разрешения редакции