Iodinated Contrast Adsorption in Cartridges With Styrene-Divinylbenzene Sorbent.

Francisco A R Neves, Massimo de Cal, Federico Ronco, Roberto Pecoits-Filho, Rinaldo Bellomo, Anna Lorenzin, Valentina Corradi, Thiago Reis, Claudio Ronco, Gonzalo Ramírez-Guerrero, Gerd Klinkmann

Journal: Artificial organs 2025;49(5):813-819

PMID: 39854063

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Abstract

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.

Address: Laboratory of Molecular Pharmacology, Faculty of Health Sciences, University of Brasília, Asa Norte, Brasília, Brazil.; Division of Nephrology, University of São Paulo Medical School, São Paulo, Brazil.; International Renal Research Institute of Vicenza (IRRIV), Vicenza, Veneto, Italy.; International Renal Research Institute of Vicenza (IRRIV), Vicenza, Veneto, Italy.; Nephrology and Dialysis Unit, Carlos van Buren Hospital, Valparaíso, Chile.; Catholic University of Paraná School of Medicine, Curitiba, Brazil.; Arbor Research Collaborative for Health, Ann Arbor, USA.; International Renal Research Institute of Vicenza (IRRIV), Vicenza, Veneto, Italy.; Department of Nephrology, Dialysis and Kidney Transplantation, San Bortolo Hospital, Vicenza, Italy.; International Renal Research Institute of Vicenza (IRRIV), Vicenza, Veneto, Italy.; Department of Anaesthesiology, Intensive Care Medicine and Pain Therapy, University of Rostock, Rostock, Germany.; Department of Extracorporeal Therapy Systems, Fraunhofer Institute for Cell Therapy and Immunology, Rostock, Germany.; Cardiology Unit & Interventional Cardiology, Ospedale dell'Angelo, Mestre, Veneto, Italy.; Laboratory of Molecular Pharmacology, Faculty of Health Sciences, University of Brasília, Asa Norte, Brasília, Brazil.; Department of Intensive Care, Austin Hospital, Melbourne, Victoria, Australia.; Critical Care, School of Medicine, University of Melbourne, Parkville, Victoria, Australia.; Australian and New Zealand Intensive Care Research Centre (ANZIC-RC), School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.; Department of Intensive Care, Royal Melbourne Hospital, Melbourne, Australia.; International Renal Research Institute of Vicenza (IRRIV), Vicenza, Veneto, Italy.; Department of Nephrology, Dialysis and Kidney Transplantation, San Bortolo Hospital, Vicenza, Italy.; Department of Medicine (DIMED), Università Degli Studi di Padova, Padova, Italy.

DOI: 10.1111/aor.14949

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MeSH Terms: Contrast Media, Iohexol, Adsorption, Humans, Polystyrenes, Acute Kidney Injury