Role of hydration in contrast-induced nephropathy in patients who underwent primary percutaneous coronary intervention

The American Journal of Cardiology
Alfonso Jurado-RománJuan Tascón

Abstract

To investigate the role of hydration to prevent contrast-induced nephropathy (CIN) in patients with ST-segment elevation myocardial infarction (STEMI) who underwent primary percutaneous coronary intervention (PPCI), we prospectively included 408 consecutive patients who were randomly assigned to receive either hydration with isotonic saline (1 ml/kg/h since the beginning of the procedure and for 24 hours after it: NS+ group) or not (NS- group). All patients received an iso-osmolar nonionic contrast medium. The primary end point was the development of CIN: ≥25% or ≥0.5 mg/dl increase in serum creatinine within 3 days after the procedure. CIN was observed in 14% of patients: 21% in the NS- group and 11% in the NS+ group (p=0.016). CIN was significantly associated with death (15.2% vs 2.8%; p<0.0001) and need for dialysis (13.4% vs 0%; p<0.0001). In multivariate analysis, the only predictors of CIN were hydration (OR=0.29 [0.14 to 0.66]; p=0.003) and the hemoglobin before the procedure (OR=0.69 [0.59 to 0.88]; p<0.0001). In conclusion, intravenous saline hydration during PPCI reduced the risk of CIN to 48%. Patients with CIN had increased mortality and need for dialysis. Given the higher incidence of CIN in emergent procedures, an...Continue Reading

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Citations

Aug 20, 2016·Cardiovascular Drugs and Therapy·George ChalikiasDimitrios N Tziakas
Feb 1, 2017·Nature Reviews. Nephrology·Michael FählingPontus B Persson
Nov 3, 2017·Coronary Artery Disease·Richard Solomon
Sep 30, 2020·British Journal of Hospital Medicine·Shuang LiuXiao-Jie Zhang
Mar 24, 2018·Current Treatment Options in Cardiovascular Medicine·Arash Ehteshami Afshar, Puja B Parikh
Feb 3, 2020·International Urology and Nephrology·Mehmet KanbayAdrian Covic
Nov 12, 2019·Japanese Journal of Radiology·Yoshitaka IsakaUNKNOWN Japanese Society of Nephrology, Japan Radiological Society, and Japanese Circulation Society Joint Working Group
Nov 9, 2019·Clinical Medicine Insights. Cardiology·Ramez MorcosBrijeshwar Maini
Nov 12, 2019·Clinical and Experimental Nephrology·Yoshitaka IsakaUNKNOWN Japanese Society of Nephrology, Japan Radiological Society, and Japanese Circulation Society Joint Working Group
May 16, 2018·Investigative Radiology·Estelle C NijssenJoachim E Wildberger
Nov 25, 2020·Angiology·Muhammad Asif KabeerSheikh Tawqeer Rashid
Dec 17, 2020·RöFo : Fortschritte auf dem Gebiete der Röntgenstrahlen und der Nuklearmedizin·Estelle Claire NijssenJoachim E Wildberger
Feb 9, 2021·Néphrologie & thérapeutique·Louis de LaforcadeUNKNOWN Commission Néphrologie Clinique de la Société Francophone de Néphrologie, Dialyse et Transplantation
Nov 12, 2019·Circulation Journal : Official Journal of the Japanese Circulation Society·Yoshitaka IsakaUNKNOWN Japanese Circulation Society Joint Working Group
Jul 13, 2021·Cardiology Clinics·Parta Hatamizadeh
Nov 22, 2020·The Journal of Thoracic and Cardiovascular Surgery·Sana Waheed, Michael J Choi
Nov 6, 2021·World Journal of Emergency Surgery : WJES·Ryo YamamotoJunichi Sasaki

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