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Association between prophylactic hydration volume and risk of contrast-induced nephropathy after emergent percutaneous coronary intervention.

Abstract：

BACKGROUND:Intravenous hydration during percutaneous coronary intervention (PCI) significantly reduces the risk of contrast-induced nephropathy (CIN), but there are no well-defined protocols regard¬ing the optimal hydration volume (HV) required to prevent CIN following emergent PCI. Therefore, this study investigates the association between the intravenous HV and CIN after emergent PCI. METHODS:711 patients were prospectively recruited who had underwent emergent PCI with hydration at routine speed and the relationship was investigated between HV or HV to weight ratio (HV/W) and the CIN risk, which was defined as a ≥ 25% or ≥ 0.5 mg/dL increase in serum creatinine levels from baseline within 48-72 h of exposure to the contrast. RESULTS:The overall CIN incidence was 24.7%. Patients in the higher HV quartiles had elevated CIN rates. Multivariate analysis showed that higher HV/W ratios were not associated with a decreased risk (using the HV) of CIN, but they were associated with an increased risk (using the HV/W) of CIN (Q4 vs. Q1: adjusted odds ratio 1.99; 95% confidence interval 1.05-3.74; p = 0.034). A higher HV/W ratio was not significantly associated with a reduced risk of long-term death (all p > 0.05). CONCLUSIONS:The data suggests that a higher total HV is not associated with a decreased CIN risk or beneficial long-term prognoses, and that excessive HV may increase the risk of CIN after emergent PCI.

journal_name

Cardiol J

journal_title

Cardiology journal

authors

Cui T,Zhao J,Bei W,Li H,Tan N,Wu D,Wang K,Guo X,Liu Y,Duan C,Chen S,Lin K,Liu Y

doi

10.5603/CJ.a2017.0048

subject

Has Abstract

pub_date

2017-01-01 00:00:00

pages

660-670

issue

6

issn

1897-5593

pii

VM/OJS/J/49133

journal_volume

24

pub_type

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