Effectiveness of aminophylline prophylaxis of renal impairment after coronary angiography in patients with chronic renal insufficiency

Abstract

This study was done to investigate whether aminophylline reduces the incidence of contrast induced nephropathy (CIN) after coronary angioplasty. Sixty patients who had serum creatinine concentration of > 1.3 mg/dl randomly received 250 mg IV aminophylline or placebo 30 minutes before coronary angiography. Serum creatinine and blood urea nitrogen were determined immediately before (base line) and at 24 and 48 hours after administration of contrast medium. The primary end point was the incidence of CIN. The incidence of CIN was 20% in placebo group and 13.3% in aminophylline group; older age was significantly associated with CIN: In this study, we could not demonstrate the prophylactic effect of a single infusion of 250 mg aminophylline, 30 minutes before administration of contrast media. A larger trial that incorporates the evaluation of clinically relevant outcomes is required to more adequately assess the role for aminophylline in CIN prevention.

Protective Effects of Anisodamine on Renal Function in Patients with ST-Segment Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention

“…A large number of drugs have been used to protect renal function after PCI, such as aminophylline (Shammas et al 2001;Rohani 2010), theophylline (Wang et al 2001), atrial natriuretic peptide (Chen 2009;Morikawa et al 2009), B-type natriuretic peptide (Zhang et al 2010), mannitol (Kelly et al 2008), prostaglandins (McCullough andTumlin 2009), N-acetylcysteine (Thiele et al 2010), sodium bicarbonate (Masuda 2008) and statins (Xinwei et al 2009); however, few of them (Kowalczyk et al 2007;Zoungas et al 2009) have shown exact protective effects.…”

Does intravenous dipyridamole administration cause acute renal impairment?

“…Increasing the concentration of adenosine in renal tissue with renal injury caused by ischemia or nephrotoxic agents supposes that adenosine is an important intrarenal factor in the pathogenesis of acute renal impairment [5]. It has also reported that inhibition of adenosine reuptake by dipyridamole induced the reduction of GFR and significantly increases the severity of renal impairment in response to CM and causes to a 70% decreasing in total reperfusion [5,28,29].…”

“…It has also reported that inhibition of adenosine reuptake by dipyridamole induced the reduction of GFR and significantly increases the severity of renal impairment in response to CM and causes to a 70% decreasing in total reperfusion [5,28,29]. In a study, Latham et al observed that dipyridamole infusion reduced renal blood flow and GFR measured by time-activity curves of left and right kidney by using Tehnetium-99-DTPA in healthy five patients [8].…”

“…It has been reported that the vascular effect of dipyridamole has been attributed to increases level of endogenous adenosine which leads to renal vasoconstriction and a reduction in GFR as declared as in pathogenesis of CIN [5,10]. So, the aim of our study is to determine whether intravenous (iv) dipyridamole administration during MPS leads to impairment of renal functions in patients with reduced GFR by measuring SCr and Cys-C levels.…”

“…Although increased extracellular adenosine causes vasodilatation in most vascular beds such as coronary and cerebrovascular system; it predominantly induces vasoconstriction in renal vascular bed and lowers glomerular filtration rate (GFR) which has been demonstrated previously [5][6][7][8]. Additionally, there is evidence that adenosine has an important role in pathophysiological process of acute reduction in renal function following contrast media (CM) exposure by inducing sustained renal vasoconstriction and a reduction in GFR [5,[9][10].…”