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Iodinated Contrast Adsorption in Cartridges With Styrene-Divinylbenzene Sorbent
Thiago Reis1,2,3, Gonzalo Ramírez-Guerrero3,4, Roberto Pecoits-Filho5,6
1Laboratory of Molecular Pharmacology, Faculty of Health Sciences, University of Brasília, Asa Norte, Brasília, Brazil.
Insights
This study shows that a scaled-down hemoadsorption cartridge effectively removes iodinated contrast, offering a potential method to prevent contrast-associated acute kidney injury (CA-AKI) in at-risk patients.
Area of Science:
- Nephrology
- Biomaterials Science
- Medical Device Engineering
Background:
- Contrast-associated acute kidney injury (CA-AKI) is a significant complication for patients with chronic kidney disease undergoing cardiac procedures.
- Iodinated contrast media used in these procedures are a primary cause of CA-AKI.
- Hemoadsorption, utilizing sorbent resin cartridges, is an emerging extracorporeal technique for blood purification.
Purpose of the Study:
- To evaluate the adsorptive kinetics of iodinated contrast medium (iohexol) using a scaled model of the HA380 hemoadsorption cartridge.
- To determine the efficiency of this cartridge in removing iohexol from blood in an in vitro setting.
Main Methods:
- An in vitro experimental study using a closed-loop extracorporeal circuit.
- A solution containing iohexol was recirculated through a 1:3 scale model of the HA380 cartridge for 60 minutes.
- Iohexol levels and clearance rates were measured at various time points.
Main Results:
- The cartridge achieved a 53% reduction in iohexol concentration after 60 minutes.
- Initial iohexol clearance was high (approx. 46.7 mL/min), decreasing over time.
- The adsorbate-to-sorbent ratio reached 155 mg/g.
Conclusions:
- A 1:3 scale HA380 cartridge model demonstrates efficient removal of iodinated contrast in an in vitro circuit.
- These findings support further investigation of hemoadsorption as a strategy to prevent or mitigate CA-AKI in clinical trials.
Background:
Contrast-associated acute kidney injury (CA-AKI) is frequent in patients with chronic kidney disease who are submitted to cardiac endovascular procedures using iodinated contrast. In hemoadsorption, cartridges containing styrene-divinylbenzene sorbent resin are applied to remove substances from the blood through an extracorporeal circuit. Importantly, iodinated contrast is also removed via adsorption. We aimed to determine the adsorptive kinetics of the iodinated contrast medium iohexol using a 1:3 scale model of the HA380 cartridge.
Methods:
An experimental in vitro study utilizing a closed-loop extracorporeal circuit with an interposed sorbent cartridge. A solution spiked with iohexol was recirculated for 60 min. Samples for the measurement of iohexol were drawn at 0, 5, 10, 15, 20, 30, 40, and 60 min. The experiment was carried out twice.
Results:
In experiments 1 and 2, the reduction ratio after 60 min was 53.0% and 53.1%, respectively. In experiment 1, iohexol clearance was 46.79 mL/min during the first 5 min and decayed to 3.57 mL/min during the last 20 min. In experiment 2, iohexol clearance was 46.72 mL/min and decayed to 3.87 mL/min during the last 20 min. The ratio of adsorbate/sorbent was 155 mg/g.
Conclusion:
A 1:3 scale model of the HA380 cartridge efficiently removes iodinated contrast in a clinical-scale in vitro circuit. These findings provide a rationale for hemoadsorption as an intervention in clinical trials to prevent or attenuate CA-AKI.
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