Effect of a contrast agent on long-term renal function and the efficacy of prophylactic hemodiafiltration.
BACKGROUND
There have been few studies regarding the effect of contrast agent on long-term renal function and, moreover, there are still many uncertainties regarding the efficacy of prophylactic hemodiafiltration (HDF) for contrast-induced nephropathy.


RESULTS
Patients with heart disease and a serum creatinine level (Scr) of less than 1.2 mg/dl were classified as Group N (20 patients), those with Scr of at least 1.2 mg/dl but less than 2.0 mg/dl were classified as Group D1 (10 patients without HDF) and D2 (15 patients with HDF), respectively. For each group, a linear regression of 1/Scr was extrapolated using Scr measured more than 3 times during each period that was longer than 3 months before and after use of a contrast agent, and the slopes (constant k) thereof were compared. To remove the contrast agent, HDF was performed for 2 h. Group D1 showed a significant decrease in the k after use of the contrast agent (p<0.05).


CONCLUSIONS
Use of a contrast agent is an independent factor that promotes chronic renal insufficiency and prophylactic HDF was found to effectively improve the long-term outcome of decreased renal function.
Shiragami
Kosaku
K
Division of Cardiology, Department of Medicine and Clinical Science, Yamaguchi University Graduate School of Medicine, Ube, Japan.
Fujii
Zenzo
Z
Sakumura
Toshihiro
T
Shibuya
Masaki
M
Takahashi
Norifumi
N
Yano
Masafumi
M
Fujii
Takashi
T
Matsuzaki
Masunori
M
D000368:Aged; D003287:Contrast Media / Q000009:adverse effects* / Q000494:pharmacology; D003404:Creatinine / Q000097:blood; D004305:Dose-Response Relationship, Drug; D005260:Female; D005500:Follow-Up Studies; D017583:Hemodiafiltration / Q000379:methods*; D006801:Humans; D007668:Kidney / Q000098:blood supply / Q000187:drug effects / Q000502:physiology*; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D051437:Renal Insufficiency / Q000097:blood / Q000139:chemically induced* / Q000517:prevention & control*; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome
D003287:Contrast Media; D003404:Creatinine