Effects of probucol on contrast-induced acute kidney injury in patients undergoing percutaneous coronary intervention

Abstract

Objective: This study was performed to explore the effects of probucol on contrast-induced acute kidney injury (CIAKI) in patients with coronary heart disease undergoing percutaneous coronary intervention (PCI). Methods: In total, 220 patients undergoing PCI were randomly assigned to either the control group (hydration from 12 hours before to 12 hours after contrast administration; n = 110) or the probucol group (hydration plus probucol 500 mg twice daily 1 day before and 3 days after the operation; n = 110). The primary endpoint was the occurrence of serum creatinine (Scr)-based CIAKI, defined as an absolute increase in Scr by 0.5 mg/dl (44.2 μmol/L) or a relative 25% increase from baseline within 48 to 72 hours after exposure to contrast medium. The secondary outcomes were composite variations in Scr, blood urea nitrogen (BUN), creatinine clearance rate (Ccr) within 48 to 72 hours, and major adverse events during hospitalization or the 7-day follow-up period after PCI. Results: The overall incidence of Scr-based CIAKI was 7.3% (16/220): 5.5% (6/110) in the control group and 9.1% (10/110) in the probucol group (χ 2 = 1.078, P = .298). There were no significant differences in the occurrence rate of major adverse events during hospitalization or the 7-day follow-up period after PCI between the groups. Multivariate logistic regression analysis showed that probucol was not an independent protective factor for CIAKI (odds ratio, 1.825; 95% confidence interval, 0.639–5.212; P = .261). However, hydration was an independent protective factor (odds ratio, 0.997; 95% confidence interval, 0.995–0.999; P = .004). Conclusion: Probucol cannot effectively reduce the incidence of CIAKI through its anti-inflammatory and antioxidative stress effects.

Contrast-Induced Acute Kidney Injury: Assessing The Effects of Pharmacological Preventive Measures

“…It reduces endogenous nitric oxide synthase inhibitor concentration, improving the renovascular endothelial function. Additionally, it increases the synthesis of prostacyclins, suppresses the expression of various adhesion molecules, and helps the proliferation of endothelial cells preventing their apoptosis due to oxidative injury [32,33]. Probucol is often used in clinical practice to prevent and treat atherosclerosis and diabetic nephropathy [34].…”

“…Oxidative stress and inflammation play an essential role in the pathogenesis of CI-AKI. The antioxidative stress and anti-inflammatory effects of probucol may help to prevent the occurrence of CI-AKI in patients greater than 18 years with coronary heart disease undergoing coronary percutaneous intervention (CPI) [32]. Probucol can prevent the occurrence of CI-AKI after coronary intervention in patients with chronic renal failure, reducing its incidence from 15% to 8% [33].…”

“…Probucol can prevent the occurrence of CI-AKI after coronary intervention in patients with chronic renal failure, reducing its incidence from 15% to 8% [33]. The doses are 500 mg twice daily, one day before and three days after operation [32,34]. The most frequent adverse effects include abdominal cramps, bloating, diarrhea, nausea, and vomiting [33].…”

“…The most frequent adverse effects include abdominal cramps, bloating, diarrhea, nausea, and vomiting [33]. Whether probucol can effectively reduce the incidence of CI-AKI requires further study in a large sample, multicenter randomized controlled trials [32][33][34].…”

Prevention of contrast-associated acute kidney injury in cancer patients undergoing radiologic investigation using contrast media; a short-review to current knowledge

“…In a study on 2,240 patients with malignancy, glomerular filtration rate below 45 mL/min/1.73 m 2 who underwent contrast-enhanced computed tomography with contrastinduced nephropathy preventive modalities Jeon et al, found, the global incidence of contrast nephropathy was 2.5%. They found that diabetes mellitus, glomerular filtration rate and plasma albumin value were independent predictors of contrast nephropathy (51,52).…”