PNNL

Abstract

Gd based contrast agents in many forms of organocomplex have recently been linked to a debilitating and a potentially fatal skin disease called Nephrogenic Systemic Fibrosis (NSF) in patients with renal failures. Free Gd released from the complexes by transmetallation is believed to be the most important trigger for NSF. Removal of Gd complex from the patients immediately after the contrast study would prevent the dissociation of Gd and should eliminate NSF as a complication. Although removal of Gd based contrast agents may be accomplished with conventional hemodialysis, it requires three hemodialysis sessions at 3 hours each to remove 98% of the contrast agents. In this work, mesoporous silica material that are functionalized with 1-hydroxy-2-pyridinone (1,2-HOPO-SAMMS®) has been evaluated for effective removal of both free and chelated Gd (Magnevist, a brand of gadopentetate dimeglumine) from the dialysate and sodium chloride solution. The material has high affinity, rapid removal rate, and large sorption capacity for both free and chelated Gd, the properties that are far superior to those of activated carbon and zirconium phosphate currently used in the state-of-the-art sorbent dialysis systems. 99% of both free and chelated Gd would be removed in a single pass thru the sorbent bed of 1,2-HOPO-SAMMS®. The sorbent provides an effective and predicable strategy for removing Gd from patients with impaired renal function, thus it would allow for the continued use of contrast MRI while removing the risk of NSF and would represent a safe alternative to traditional contrast studies in the patient population.