Polymorphism of Oxidative Stress Genes in the Pathogenesis and Antioxidant Prevention of Contrast Induced Nephropathy
Status:
Completed
Trial end date:
2011-03-01
Target enrollment:
Participant gender:
Summary
With the wide use of contrast agents in clinical diagnosis and treatment, contrast induced
nephropathy(CIN) accounts for 1/3 of hospital acquired acute renal failure.The mortality rate
of patients with CIN is up to 35%,and about 30% patients with permanent renal
dysfunction.Prevention and treatment of this iatrogenic complication and reducing morbidity
has become an urgent task to every medical worker.
Now the pathogenesis of CIN is not clear,while the toxicity of renal tubular epithelial cell
and the hypoxia of renal medullary is likely to be the main mechanism of CIN.Iodine contrast
agent concentrate in the tubular and collecting duct and directly damage cells,leading to
tubular cell death;also induce the release of renal vasoconstrictors,such as adenosine,
endothelin, causing acute vasoconstriction.Furthermore,oxidative stress and the inflammatory
response induced by ischemia may worsen kidney function.
Thus a large number of studies focus on oxidative stress in the pathogenesis of
CIN.Recently,some studies have shown that oxidative stress proteins play an important role in
acute renal injury(AKI),and have reported that these proteins of different genotypes related
to the incidence and prognosis of AKI.
Therefore,the investigators speculate whether some patients have genetic potential of
increased oxidative stress,and are more prone to contrast induced nephropathy? At
present,there are a great number of researches about preventive measures of CIN.The firstly
and widely used therapy is hydration.But it just dilutes iodine contrast medium in renal
tubular and collecting duct,increases urine output to prevent the formation of tubular
crystals.According to the pathogenesis of CIN,oxidative stress plays an important role in
CIN,thereby several antioxidants,such as N-acetyl cysteine or Glutathione are also under
study.But results are inconsistent.
As a result,the investigators designed this study to evaluate the oxidative stress in
cardiovascular population on the impact of contrast medium nephropathy,and the relationship
in antioxidant enzymes with genetic polymorphisms,to find clinical indicators predicting
renal dysfunction and guiding individual treatment to prevent its occurrence.