Ischemia Modified Albumin And Paraoxonase-1 Levels In Serum of Patients With Malignancy Undergoing Intravenous Contrast Enhanced Computed Tomography As Biochemical Markers

INTRODUCTION: Following contrast enhanced computed tomography (CECT)adverse effects including contrast induced nephropathy (CIN) is a risk in patients with renal insufficiency, diabetes and malignancy. Administration of contrast media (CM) in CECT, puts patients with malignancy at further risk of oxidative stress and damage. Estimating serum Ischemia modified albumin (IMA) as an early marker for acute ischemia and oxidative stress and then correlating it with paraoxonase-1 (PON-1) levels in this group of patients before and after CECT may add to information regarding oxidative status of the patient. OBJECTIVES: To estimate serum levels of IMA and PON-1 in patients with malignancy before and after an intravenous CECT procedure MATERIALS AND METHODS: 22 adult in-patients with malignancy regardless of type of malignancy and body region were included in this prospective study. Venousblood samples were obtained 12-24 hours before and 12-24 hours after contrast media administration in CECT. Serum IMA and PON-1 levels were estimated using methods described by Bar-Or et al., and Dantoine et. al., respectively. RESULTS: The mean IMA levels in post-CECT (0.83 [+ or -] 0.40) patients was higher compared to the pre-CECT patients (0.71 [+ or -] 0.45). In post-CECT samples, PON-1 levels (47.3 [+ or -] 18.6) were lower compared to pre-CECT patients (54.0 [+ or -] 20.4) CONCLUSION: Our study shows that IMA increases and PON-1 decreases post CECT. Such altered levels could be associated with ischemia/oxidative activity following CM administration. A combined estimation of these parameters may identify patients at risk for adverse effects of CECT including CIN. KEY WORDS: Contrast induced nephropathy, paraoxonase-1, Serum IMA, PON-1