Short- and long-term renal outcomes of immediate prophylactic hemodialysis after cardiovascular catheterizations in patients with severe renal insufficiency.
BACKGROUND
The short- and long-term effects of prophylactic hemodialysis (HD) immediately after cardiovascular catheterizations on renal function in patients with severe baseline renal insufficiency remain unknown though previous studies reported non-beneficial very-short-term effect in less severe patients.


RESULTS
Patients who had pre-procedural serum creatinine (Scr) between 2.5 and 5.5 mg/dl were retrospectively studied. Twenty of them (14 M/6 F, aged 69 +/- 2 years) had received prophylactic HD after radiocontrast exposure and constituted the HD group. Another 20 patients were case-matched to the baseline demographics of the HD group and served as the non-HD group. The baseline Scr were 3.9 +/- 0.2 and 3.5 +/-0.2 mg/dl, respectively (p = NS). Although the Scr at 3 months was significantly higher in the HD group (4.3 +/- 0.3 vs. 3.4 +/- 0.2 mg/dl, p = 0.02), the absolute and percentage increments from baseline to 3 months (0.4 +/- 0.2 vs. 0.0 +/- 0.2 mg/dl, p = NS, and 11 +/- 5% vs. 1 +/- 7%, p = NS, respectively) and 6 months (0.6 +/- 0.3 vs. 0.4 +/- 0.4 mg/dl, p = NS, and 18 +/- 8% vs. 8 +/- 10%, p = NS, respectively) were not statistically different. Patients who developed end-stage renal disease requiring permanent HD at 1 year were also similar in both groups (four vs. three, respectively, p = NS).


CONCLUSIONS
Our study confirmed that prophylactic HD immediately after contrast media administration in catheterizations failed to affect the short- and long-term renal and clinical outcomes even in patients with severe baseline renal insufficiency.
Hsieh
Yu-Cheng
YC
Division of Cardiology, Department of Medicine, Taichung Veterans General Hospital, Taiwan.
Ting
Chih-Tai
CT
Liu
Tsun-Jui
TJ
Wang
Chia-Liang
CL
Chen
Ying-Tsung
YT
Lee
Wen-Lieng
WL
D058186:Acute Kidney Injury / Q000139:chemically induced / Q000517:prevention & control*; D000368:Aged; D000789:Angina, Unstable / Q000150:complications / Q000000981:diagnostic imaging*; D006328:Cardiac Catheterization / Q000009:adverse effects*; D003287:Contrast Media / Q000009:adverse effects; D017023:Coronary Angiography / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007472:Iohexol / Q000009:adverse effects / Q000031:analogs & derivatives; D007676:Kidney Failure, Chronic / Q000150:complications*; D008297:Male; D006435:Renal Dialysis; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome
D003287:Contrast Media; D007472:Iohexol; C038192:iopromide