Preventive Effects of Alprostadil Against Contrast-Induced Nephropathy Inpatients With Renal Insufficiency Undergoing Percutaneous Coronary Intervention

Yang, Shicheng; Fu, Naikuan; Zhang, Jing; Liang, Min; Cong, Hongliang; Lin, Wenhua; Tian, Fengshi; Lu, Chengzhi; Sun, Tao; Zhang, Wenya; Ma, Zhenhua

doi:10.1177/0003319717730942

Cited by 10 publications

(11 citation statements)

References 26 publications

(35 reference statements)

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“…26 A recent study demonstrated the preventive effects of alprostadil on the development of CIN in patients with renal insufficiency undergoing percutaneous coronary intervention (PCI). 27…”

Section: Discussionmentioning

confidence: 99%

The Ratio of Fibrinogen to Albumin as a Predictor of Contrast-Induced Nephropathy After Carotid Angiography

2018

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Contrast-induced nephropathy (CIN) is acute kidney failure that occurs after exposure to contrast agent. There is no sensitive biomarker to predict the development of CIN. In a retrospective study, we investigated the predictive value of the fibrinogen to albumin ratio (FAR) to determine the risk of CIN in patients (N = 246) who underwent carotid angiography. Contrast-induced nephropathy was defined as a 0.5 mg/dL or 25% increase in serum creatinine levels 48 to 72 hours following exposure to a radiocontrast agent. Patients were grouped according to whether they developed CIN or not, that is, CIN(–) and CIN(+) groups, respectively. Contrast-induced nephropathy developed in 39 (15.8%) of all the patients. The fibrinogen levels, neutrophil to lymphocyte ratio (NLR), and FAR in the CIN (+) group were higher than in the CIN (−) group ( P < .001). Multivariate analysis showed that age, diabetes, NLR, platelet–lymphocyte ratio, and FAR were independent risk factors for CIN. The area under the curve (AUC) of FAR was 0.800 for the prediction of CIN, and the best cutoff value was 57.4 with sensitivity, specificity, positive predictive value, and negative predictive value of 74.4%, 60.8%, 26.4%, and 92.7%, respectively. The FAR may be useful as a predictor of CIN.

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“…26 A recent study demonstrated the preventive effects of alprostadil on the development of CIN in patients with renal insufficiency undergoing percutaneous coronary intervention (PCI). 27…”

Section: Discussionmentioning

confidence: 99%

The Ratio of Fibrinogen to Albumin as a Predictor of Contrast-Induced Nephropathy After Carotid Angiography

2018

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“…The qualified articles were then downloaded for detailed assessment. Finally, data for 5495 patients extracted from 36 articles 25 –60 were used in this meta-analysis. A total of 2746 patients were in the experimental group and 2749 patients were in the control group.…”

Section: Resultsmentioning

confidence: 99%

“…All 36 studies were RCTs and mentioned that a randomization method was used, but some of the articles described the blind method. 25 –60 Selective reporting of the results, incomplete data outcome, and other biases in the articles were low. The literature quality score is shown in Table 2.…”

Section: Resultsmentioning

confidence: 99%

Effect of Alprostadil on the Prevention of Contrast-Induced Nephropathy: A Meta-Analysis of 36 Randomized Controlled Trials

et al. 2019

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Contrast-induced nephropathy (CIN) is the third leading cause of acquired acute renal injury in hospitalized patients. Alprostadil plays a role in the maintenance and redistribution of intrarenal blood flow and the excretion of electrolytes and water. However, the effectiveness of alprostadil in preventing CIN remains controversial. Thirty-six articles with a total of 5495 patients were included in this study. Both groups (experimental group and control group) received standard hydration therapy. In the experimental group, patients received different doses of alprostadil. Serum creatinine (SCr), blood urea nitrogen (BUN), estimated glomerular filtration rate (eGFR), cystatin C, creatinine clearance rate (CCr), and β2-microglobulin (β2-MG) were measured at 24, 48, and 72 hours after contrast media injection. The incidence of CIN in the experimental group was significantly lower than that in the control group (6.56% vs 16.74%). The level of SCr, cystatin C, BUN, and β2-MG in the experimental group was lower than those in the control group; CCr and eGFR in the experimental group were higher than those in the control group. This study demonstrated that alprostadil may reduce the incidence of CIN in patients undergoing coronary angiogram and/or percutaneous coronary intervention.

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“…The first was a multivariate logistic regression analysis to assess the association of BMI with V/CrCl>3, excluding the 3832 patients with complex lesions (PCI of the left main coronary artery, type C lesion, bifurcation lesion, chronic total occlusion lesion, Rotablator use, multivessel PCI) because lesion complexity may affect CV [ 28 , 29 ]. Second, we analyzed associations with CV, V/CrCl ratio, and BMI for the 3283 patients with a CrCl <60 mL/min (indicative of a high CI-AKI risk) in a subgroup analysis [ 22 , 30 ].…”

Section: Methodsmentioning

confidence: 99%

Effects of body habitus on contrast-induced acute kidney injury after percutaneous coronary intervention

et al. 2018

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BackgroundLimiting the contrast volume to creatinine clearance (V/CrCl) ratio is crucial for preventing contrast-induced acute kidney injury (CI-AKI) after percutaneous coronary intervention (PCI). However, the incidence of CI-AKI and the distribution of V/CrCl ratios may vary according to patient body habitus.ObjectiveWe aimed to identify the clinical factors predicting CI-AKI in patients with different body mass indexes (BMIs).MethodsWe evaluated 8782 consecutive patients undergoing PCI and who were registered in a large Japanese database. CI-AKI was defined as an absolute serum creatinine increase of 0.3 mg/dL or a relative increase of 50%. The effect of the V/CrCl ratio relative to CI-AKI incidence was evaluated within the low- (≤25 kg/m2) and high- (>25 kg/m2) BMI groups, with a V/CrCl ratio > 3 considered to be a risk factor for CI-AKI.ResultsA V/CrCl ratio > 3 was predictive of CI-AKI, regardless of BMI (low-BMI group: odds ratio [OR], 1.77 [1.42–2.21]; P < 0.001; high-BMI group: OR, 1.67 [1.22–2.29]; P = 0.001). The relationship between BMI and CI-AKI followed a reverse J-curve relationship, although baseline renal dysfunction (creatinine clearance <60 mL/min, 46.9% vs. 21.5%) and V/CrCl ratio > 3 (37.3% vs. 20.4%) were predominant in the low-BMI group. Indeed, low BMI was a significant predictor of a V/CrCl ratio > 3 (OR per unit decrease in BMI, 1.08 [1.05–1.10]; P < 0.001).ConclusionsA V/CrCl ratio > 3 was strongly associated with the occurrence of CI-AKI. Importantly, we also identified a tendency for physicians to use higher V/CrCl ratios in lean patients. Thus, recognizing this trend may provide a therapeutic target for reducing the incidence of CI-AKI.

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Preventive Effects of Alprostadil Against Contrast-Induced Nephropathy Inpatients With Renal Insufficiency Undergoing Percutaneous Coronary Intervention

Cited by 10 publications

References 26 publications

The Ratio of Fibrinogen to Albumin as a Predictor of Contrast-Induced Nephropathy After Carotid Angiography

The Ratio of Fibrinogen to Albumin as a Predictor of Contrast-Induced Nephropathy After Carotid Angiography

Effect of Alprostadil on the Prevention of Contrast-Induced Nephropathy: A Meta-Analysis of 36 Randomized Controlled Trials

Effects of body habitus on contrast-induced acute kidney injury after percutaneous coronary intervention

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