Abstract:
Contrast-induced acute kidney injury (CI-AKI) is a frequent challenge following the injection of contrast media and its subsequent oxidative stress. The aim of the present study was to evaluate the preventive effects of coenzyme Q10 (Q10), as a mitochondrial-targeted antioxidant in CI-AKI in diabetic patients, who account for a large proportion of angiographic cases. A total of 118 diabetic patients were randomly assigned to receive 120 mg of oral coenzyme Q10 (Q10 group) or placebo (Placebo group) for four days, starting 24 hours before contrast media injection. Blood urea nitrogen (BUN), serum and urinary creatinine, estimated glomerular filtration rate (eGFR), urinary malondialdehyde (UMDA), urinary total antioxidant capacity (UTAC), and urinary mitochondrial to nuclearDNA ratios (mtDNA/nDNA ratio) were evaluated before and after the treatment period. Urine sediments were also evaluated to report the urine microscopy score (UMS).The levels of BUN, serum and urine creatinine, and UMS were similar in the Q10 and placebo groups. EGFR was lower in the Q10 group before the treatment (p=0.013) but not after. The urinary mtDNA/nDNA ratio was 3.05±1.68 and 3.69±2.58 in placebo and Q10 groups, but UTAC was found to be lower in Q10 both before (p=0.006) and after the treatment (p<0.001). The incidence of CI-AKI was 14.40% and the mtDNA/nNDA ratio was similar between CI-AKI and non-CI-AKI patients. In conclusion, Q10 treatment shows no favorable effect on prevention of CI-AKI or a urinary mtDNA/nDNA ratio among diabetic patients.
摘要:
造影剂诱导的急性肾损伤(CI-AKI)是造影剂注射及其随后的氧化应激后的常见挑战。本研究的目的是评估辅酶Q10(Q10)的预防作用,作为糖尿病患者CI-AKI的线粒体靶向抗氧化剂,在血管造影病例中占很大比例。总共118名糖尿病患者被随机分配接受120mg口服辅酶Q10(Q10组)或安慰剂(安慰剂组),持续4天,造影剂注射前24小时开始。血尿素氮(BUN),血清和尿肌酐,估计肾小球滤过率(eGFR),尿丙二醛(UMDA),尿总抗氧化能力(UTAC),在治疗前后评估了线粒体与核DNA的比率(mtDNA/nDNA比率)。还评估了尿液沉积物以报告尿液显微镜评分(UMS)。BUN的水平,血清和尿肌酐,Q10组和安慰剂组的UMS相似。治疗前Q10组的EGFR较低(p=0.013),但治疗后没有。安慰剂组和Q10组尿mtDNA/nDNA比值分别为3.05±1.68和3.69±2.58,但在治疗前(p=0.006)和治疗后(p<0.001),在Q10中发现UTAC较低。CI-AKI的发生率为14.40%,CI-AKI患者与非CI-AKI患者的mtDNA/nNDA比值相似。总之,在糖尿病患者中,Q10治疗对预防CI-AKI或尿mtDNA/nDNA比率没有良好作用。