Iodinated Contrast Adsorption in Cartridges With Styrene‐Divinylbenzene Sorbent

• Published in: Artificial organs Vol. 49; no. 5; pp. 813 - 819
• Main Authors: Reis, Thiago, Ramírez‐Guerrero, Gonzalo, Pecoits‐Filho, Roberto, Lorenzin, Anna, Cal, Massimo, Corradi, Valentina, Klinkmann, Gerd, Ronco, Federico, Neves, Francisco A. R., Bellomo, Rinaldo, Ronco, Claudio
• Format: Journal Article
• Language: English
• Published: United States Wiley Subscription Services, Inc 01.05.2025
• Subjects: Acute Kidney Injury - chemically induced; Acute Kidney Injury - prevention & control; Adsorption; Adsorptivity; blood purification; Cardiovascular system; Cartridges; Clinical trials; Contrast media; Contrast Media - adverse effects; Contrast Media - chemistry; Divinylbenzene; Heart diseases; hemoadsorption; Humans; In vitro methods and tests; iodinated contrast; Iohexol - chemistry; Kidney diseases; Kidneys; Polystyrenes - chemistry; Scale models; Sorbents; Styrene; Styrenes; blood purification; iodinated contrast; adsorption; hemoadsorption; cartridges
• ISSN: 0160-564X; 1525-1594; 1525-1594
• DOI: 10.1111/aor.14949

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. A 1:3 scale model of the HA380 cartridge containing styrene‐divinylbenzene resin removes iodinated contrast in an extracorporeal blood purification circuit. In proportion, the mass removed would represent two‐thirds of the amount administered in major cardiac endovascular interventions. This provides a rationale for hemoadsorption as an intervention in clinical trials to prevent contrast‐associated acute kidney injury.