title: Impact of mannose-binding lectin deficiency on radiocontrast-induced renal dysfunction: a post-hoc analysis of a multicenter randomized controlled trial.
abstract: BACKGROUND
  Local renal ischemia is regarded as an important factor in the development of contrast-induced nephropathy (CIN). Mannose-binding lectin (MBL) is involved in the tissue damage during experimental ischemia/reperfusion injury of the kidneys. The aim of the present study was to investigate the association of MBL deficiency with radiocontrast-induced renal dysfunction in a large prospective cohort.
  
  
  METHODS
  246 patients with advanced non-dialysis-dependent renal dysfunction who underwent radiographic contrast procedures were included in the study. Baseline serum MBL levels were analyzed according to the occurrence of a creatinine-based (increase of ≥ 0.5 mg/dL or ≥ 25% within 48 hours) or cystatin C-based (increase of ≥ 10% within 24 hours) CIN.
  
  
  RESULTS
  The incidence of creatinine-based and cystatin C-based CIN was 6.5% and 24%, respectively. MBL levels were not associated with the occurrence of creatinine-based CIN. However, patients that experienced a cystatin C increase of ≥ 10% showed significantly higher MBL levels than patients with a rise of <10% (median 2885 (IQR 1193-4471) vs. 1997 (IQR 439-3504)ng/mL, p = 0.01). In logistic regression analysis MBL deficiency (MBL levels ≤ 500 ng/ml) was identified as an inverse predictor of a cystatin C increase ≥ 10% (OR 0.34, 95% CI 0.15-0.8, p = 0.01).
  
  
  CONCLUSIONS
  MBL deficiency was associated with a reduced radiocontrast-induced renal dysfunction as reflected by the course of cystatin C. Our findings support a possible role of MBL in the pathogenesis of CIN.
authors.affiliation: Laboratory of Clinical Immunology, Department of Biomedicine, University Hospital Basel, Basel, Switzerland.
authors.forename: Michael
authors.initials: M
authors.lastname: Osthoff
authors.forename: Vanja
authors.initials: V
authors.lastname: Piezzi
authors.forename: Theresia
authors.initials: T
authors.lastname: Klima
authors.forename: Andreas
authors.initials: A
authors.lastname: Christ
authors.forename: Ivana
authors.initials: I
authors.lastname: Marana
authors.forename: Sabine
authors.initials: S
authors.lastname: Hartwiger
authors.forename: Tobias
authors.initials: T
authors.lastname: Breidthardt
authors.forename: Giancarlo
authors.initials: G
authors.lastname: Marenzi
authors.forename: Marten
authors.initials: M
authors.lastname: Trendelenburg
authors.forename: Christian
authors.initials: C
authors.lastname: Mueller
mesh_terms: D058186:Acute Kidney Injury; D000368:Aged; D015415:Biomarkers / Q000097:blood; D003287:Contrast Media; D055316:Cystatin C / Q000097:blood*; D064420:Drug-Related Side Effects and Adverse Reactions / Q000097:blood* / Q000453:epidemiology*; D005260:Female; D006801:Humans; D017613:Iodine Compounds; D008297:Male; D037601:Mannose-Binding Lectin / Q000097:blood*; D015995:Prevalence; D015203:Reproducibility of Results; D012307:Risk Factors; D012680:Sensitivity and Specificity; D013557:Switzerland / Q000453:epidemiology
chemical_list: D015415:Biomarkers; D003287:Contrast Media; D055316:Cystatin C; D017613:Iodine Compounds; D037601:Mannose-Binding Lectin