title: Prostaglandin E1: a new agent for the prevention of renal dysfunction in high risk patients caused by radiocontrast media? PGE1 Study Group.
abstract: BACKGROUND
  Acute renal failure following the administration of radiocontrast media (RCM) is a complication found especially in patients with impaired renal function. Within the limits of a pilot study, the objective was to (a) show the effectiveness and compatibility of prostaglandin E(1) (PGE(1)=Alprostadil) in preventing acute renal failure in patients with elevated levels of serum creatinine and (b) to identify the most appropriate PGE(1)-dose.
  
  
  METHODS
  130 patients with renal impairment (serum creatinine >/=1.5 mg/dl) were included in the study prior to intravascular RCM injection. The patients received one of three different doses of PGE(1) (10, 20, or 40 ng/kg bodyweight/min) or placebo (physiologic sodium chloride solution) intravenously over a time period of 6 h (beginning 1 h prior to RCM application). Serum creatinine was measured 12, 24, and 48 h post RCM-application and creatinine clearance was determined with two 12 h collection periods, as well as one 24 h collection within 48 h post RCM administration. Adverse events during PGE(1) administration were recorded.
  
  
  RESULTS
  In the placebo group, the mean elevation of serum creatinine was markedly higher (0.72 mg/dl) 48 h after RCM administration compared with the three PGE(1) groups (0.3 mg/dl in the 10 ng/kg/min group, 0. 12 mg in the 20 ng/kg/min group, and 0.29 mg/dl in the 40 ng/kg/min group). No clinically relevant changes were seen regarding the creatinine clearance in the four groups examined.
  
  
  CONCLUSIONS
  Results from this pilot-study suggest that intravenous PGE(1) may be used efficaciously and safely to prevent RCM-induced renal dysfunction in patients with pre-existing impaired renal function.
authors.affiliation: Department of Diagnostic Radiology and Department of Nephrology and Rheumatology, Heinrich-Heine-University, Düsseldorf, Germany.
authors.forename: J A
authors.initials: JA
authors.lastname: Koch
authors.forename: J
authors.initials: J
authors.lastname: Plum
authors.forename: B
authors.initials: B
authors.lastname: Grabensee
authors.forename: U
authors.initials: U
authors.lastname: Mödder
mesh_terms: D058186:Acute Kidney Injury / Q000209:etiology / Q000517:prevention & control*; D000328:Adult; D000368:Aged; D000527:Alprostadil / Q000008:administration & dosage / Q000009:adverse effects / Q000494:pharmacology*; D003287:Contrast Media / Q000009:adverse effects*; D003404:Creatinine / Q000097:blood; D048909:Diabetes Complications; D004311:Double-Blind Method; D004361:Drug Tolerance; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D007668:Kidney / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D012307:Risk Factors
chemical_list: D003287:Contrast Media; D003404:Creatinine; D000527:Alprostadil