Haemodialysis for the prevention of contrast-induced nephropathy: outcome of 31 patients with severely impaired renal function, comparison with patients at similar risk and review.
OBJECTIVE
To investigate whether haemodialysis prevents contrast-induced nephropathy (definition: increase of serum-creatinine of >or= 0.5 mg/dL within 7 days).


METHODS
Thirty-one patients (mean serum-creatinine 4.01 +/- 1.83 mg/dL) were dialyzed for 4.36 +/- 1.0 hours within one hour after 278.4 +/- 160.5 mL of contrast medium.


RESULTS
Dialysis resulted in a significant reduction of serum-creatinine (2.25 +/- 1.46 mg/dL; P< 0.0001) and stable mean serum-creatinine levels 2, 3, 4, and 7 days after contrast medium and at discharge compared with baseline values. However, 19 patients (61%) developed contrast-induced nephropathy within 7 days. Four patients had to be repeatedly dialyzed. A comparison of our patients' 48 hours-incidence of contrast-induced nephropathy (9/31; 29%) versus patients at comparable risk included in seven previous studies demonstrated a prophylactic effect of dialysis only versus a subgroup in one study.


CONCLUSIONS
Data provide no hint that haemodialysis prevents contrast-induced nephropathy. Therefore, postprocedural dialysis should be restricted to patients participating in clinical studies.
Huber
Wolfgang
W
Department of Internal Medicine II, Klinikum Rechts der Isar, Technical University of Munich, Germany. Wolfgang.Huber@t-online.de
Jeschke
Barbara
B
Kreymann
Bernhard
B
Hennig
Michael
M
Page
Michael
M
Salmhofer
Hermann
H
Eckel
Florian
F
Schmidt
Ulrike
U
Umgelter
Andreas
A
Schweigart
Ursula
U
Classen
Meinhard
M
D058186:Acute Kidney Injury / Q000097:blood / Q000209:etiology* / Q000517:prevention & control*; D000328:Adult; D000368:Aged; D003287:Contrast Media / Q000009:adverse effects*; D003404:Creatinine / Q000097:blood; D006801:Humans; D007677:Kidney Function Tests; D008875:Middle Aged; D011446:Prospective Studies; D006435:Renal Dialysis; D013997:Time Factors; D016896:Treatment Outcome
D003287:Contrast Media; D003404:Creatinine