Comparison of oral and intravenous hydration strategies for the prevention of contrast-induced nephropathy in patients undergoing coronary angiography or angioplasty: a randomized clinical trial

Acta Cardiol. 2012 Oct;67(5):565-9. doi: 10.1080/ac.67.5.2174131.

Abstract

Objective: The efficacy of oral hydration in the prevention of contrast-induced nephropathy in patients undergoing elective coronary intervention is unclear.

Methods: A total of 120 patients were randomly assigned to three groups. Group A (n = 40) received intravenous hydration before and after coronary angiography or angioplasty. Group B (n = 40) received oral tap water before and after the procedures, whereas group C (n = 40) received only postprocedural drinking water. Levels of serum creatinine and urea nitrogen were measured before, 12 hours after, 2 and 3 days after the coronary angiography or angioplasty.

Results: : There was no statistically significant difference in the age, sex, baseline renal function and the volume of contrast medium used during the coronary procedures among the three groups (P > 0.05).There was no statistically significant difference in the mean serum creatinine or urea nitrogen among the three groups 12 hours, and 3 days after the coronary procedures ( P > 0.05).The incidence of contrast-induced nephropathy in group A, B and C was 5.0% (2/40), 7.5% (3/40) and 5.0% (2/40), respectively (P = 0.86). Renal function in the seven patients who experienced contrast-induced nephropathy recovered within a week following rehydration treatment.

Conclusions: Pre- and post-procedural oral hydration was as effective as intravenous rehydration in the prevention of contrast-induced nephropathy in patients undergoing coronary angiography or angioplasty.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Administration, Oral
  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Angioplasty, Balloon, Coronary / adverse effects*
  • Contrast Media / adverse effects*
  • Coronary Angiography / adverse effects*
  • Coronary Disease / diagnostic imaging
  • Coronary Disease / therapy
  • Drinking Water / administration & dosage*
  • Female
  • Fluid Therapy / methods*
  • Follow-Up Studies
  • Humans
  • Infusions, Intravenous
  • Isotonic Solutions / administration & dosage*
  • Kidney Diseases / chemically induced
  • Kidney Diseases / prevention & control*
  • Male
  • Middle Aged
  • Practice Guidelines as Topic
  • Retrospective Studies
  • Treatment Outcome
  • Young Adult

Substances

  • Contrast Media
  • Drinking Water
  • Isotonic Solutions