Incidence of contrast-induced nephropathy with volume supplementation--insights from a large cohort

Med Princ Pract. 2008;17(5):409-14. doi: 10.1159/000141507. Epub 2008 Aug 6.

Abstract

Objective: The present study was performed to determine the effect of combined intravenous and oral volume supplementation on the incidence of contrast-induced nephropathy (CIN) in patients undergoing percutaneous coronary intervention (PCI).

Subjects and methods: Consecutive patients (n = 958) receiving iomeprol 350 during PCI were evaluated prospectively for the development of CIN. All patients received protocol-defined intravenous and oral volume supplementation. CIN was defined as an increase in serum creatinine of at least 44 micromol/l within 48 h.

Results: Of the 958 patients enrolled in the study, 147 (15%) were diabetic and 107 (11%) had stage III renal disease. The average baseline glomerular filtration rate was 88 +/- 25 ml/min/1.73 m(2). During the intervention an average of 238 +/- 86 ml of contrast medium was administered. CIN developed in 13 of 958 (1.4%; 95% confidence interval 0.6-2.1%) patients. The incidence of CIN was low even in predefined risk subgroups (women: 2.4%, diabetics: 2.7%, patients with stage III kidney disease: 6.5%).

Conclusions: The incidence of CIN is low when preprocedural fluid volume supplementation is used.

Publication types

  • Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acute Kidney Injury / chemically induced
  • Acute Kidney Injury / epidemiology*
  • Acute Kidney Injury / therapy
  • Aged
  • Angioplasty, Balloon, Coronary* / methods
  • Blood Volume*
  • Cohort Studies
  • Contrast Media / adverse effects*
  • Female
  • Glomerular Filtration Rate / drug effects
  • Humans
  • Incidence
  • Iopamidol / adverse effects
  • Iopamidol / analogs & derivatives*
  • Isotonic Solutions / administration & dosage*
  • Male
  • Middle Aged
  • Prospective Studies
  • Water-Electrolyte Balance

Substances

  • Contrast Media
  • Isotonic Solutions
  • iomeprol
  • Iopamidol