Urinary Metabolomic Analysis to Detect Changes After Intravenous, Non-ionic, Low Osmolar Iodinated Radiocontrast for Computerized Tomographic Imaging

• Main Authors: Deborah B Diercks, Kelly P. Owen, Vladimir Tolstikov, Mark E. Sutter, Jeffrey A. Kline
• Format: Article
• Language: English
• Published: eScholarship Publishing, University of California 2014-03-01
• Series: Western Journal of Emergency Medicine
• Subjects: metabolomics; contrast; nephropathy; computerized tomographic imaging; emergency medicine
• Online Access: http://escholarship.org/uc/item/6300428r#

Introduction: Contrast-induced nephropathy is a result of injury to the proximal tubules caused by oxidative stress and ischemia. Metabolomics is a novel technique that has been used to identify renal damage from drug toxicities. The objective of this study is to analyze the metabolic changes in the urine after dosing with intravenous (IV) contrast for computed tomograph (CT) of the chest Methods: A convenience sample of patients undergoing a chest CT with IV contrast who had at least one of the following: age ≥50 years, diabetes, heart failure, chronic kidney disease, coronary artery disease, or diastolic blood pressure >90 mmHg -- were eligible for enrollment. Urine samples were collected prior to imaging and 4-6 hours post imaging. Samples underwent gas chromography/mass spectrometry profiling. We measured peak metabolite values and log transformed data. Paired T tests were calculated. We used significance analysis of microarrays (SAM) to determine the most significant metabolites. Results: The cohort comprised 14 patients with matched samples; 9 /14 (64.3) were males, and the median age was 61 years (IQR 50-68). A total of 158 metabolites were identified. Using SAM we identified 9 metabolites that were identified as significant using a delta of 1.6. Conclusion: Changes in urinary metabolites are present soon after contrast administration. This change in urinary metabolites may be potential early identifiers of contrast-induced nephropathy and could identify patients at high-risk for developing this condition. [West J Emerg Med. 2014;15(2):152–157.]