Post-Hoc Study: Intravenous Hydration Treatment in Chinese Patients with High Risk of Contrast-Induced Nephropathy Following Percutaneous Coronary Intervention

Abstract

Contrast-induced nephropathy (CIN) develops after the injection of iodinated contrast media. This is a post hoc analysis of the data obtained from the TRUST study, which was a prospective, multicentre, observational study conducted to evaluate the safety and tolerability of the contrast medium iopromide in patients undergoing cardiac catheterization from August 2010 to September 2011 in China, conducted to explore the current status, trends and risk predictors of hydration treatment. The status of hydration to prevent CIN in each patient was recorded. Of the total 17,139 patients from the TRUST study (mean age, 60.33 ± 10.38 years), the overall hydration usage was 46.1% in patients undergoing percutaneous coronary intervention (PCI) and 77.4%, 51.7%, and 48.5% in patients with pre-existing renal disease, diabetes mellitus, and hypertension, respectively. The proportion of hydration use increased from 36.5% to 55.5% from August 2010 to September 2011, which was independently associated with risk predictors like older age, pre-existing renal disease, hypertension, diabetes mellitus, prior myocardial infarction, ST segment elevation MI, high contrast dose, multi-vessel disease and reduced LVEF (<45%). Overall, the usage of intravenous hydration treatment for patients with a high risk of CIN following PCI was high in China.

Growth differentiation factor-15 levels and the risk of contrast induced nephropathy in patients with acute myocardial infarction undergoing percutaneous coronary intervention: A retrospective observation study

“…Except for GDF-15, Our logistic regression model showed that anemia, primary PCI and eGFR <90ml/min/1.73m 2 are also independent risk factors for CIN, which is coinciding with previous study[ 31 – 33 ]. Roman reported that anemia and renal dysfunction were predictors of CIN in patients undergoing primary PCI[ 34 ].…”

“…Roman reported that anemia and renal dysfunction were predictors of CIN in patients undergoing primary PCI[ 34 ]. Other predictors for CIN include old age, hypertension, diabetes mellitus, high contrast dose, multi-vessel diseases, et al[ 31 – 33 ]. In our study, we didn’t find their predictive value of these predictors.…”

Coenzyme Q10 combined with trimetazidine in the prevention of contrast-induced nephropathy in patients with coronary heart disease complicated with renal dysfunction undergoing elective cardiac catheterization: a randomized control study and in vivo study

“…The clinical and basic research of CIN has become the hot spot currently. Hydration and maintenance of circulating volume are still the main measurement to prevent contrast nephropathy [ 9 ]. Clinical studies also showed that several drugs can prevent contrast nephropathy, including antioxidants ( N -acetylcysteine, statins), diuretic (furosemide), and vasodilators (such as calcium antagonists, dopamine, fenoldopam) [ 10 , 11 ].…”

Proper hydration in contrast-induced nephropathy among patients with acute myocardial infarction and cardiac insufficiency

“…Several previous studies have explored the optimal hydration strategy [15][16][17], but the guidelines for patients with cardiac insufficiency still don't have specific hydration strategy recommendation, especially in patients with cardiac insufficiency [18]. The recommended prevention for CIN was routine hydration 12 hour before and 6-24 hour after the procedure with saline at regular speed(1 ml/kg/h or 0.5ml/kg/h for patients with NYHA>II or LVEF<35%).…”