Incidence of contrast-induced nephropathy with volume supplementation--insights from a large cohort.
OBJECTIVE
The present study was performed to determine the effect of combined intravenous and oral volume supplementation on the incidence of contrast-induced nephropathy (CIN) in patients undergoing percutaneous coronary intervention (PCI).


METHODS
Consecutive patients (n = 958) receiving iomeprol 350 during PCI were evaluated prospectively for the development of CIN. All patients received protocol-defined intravenous and oral volume supplementation. CIN was defined as an increase in serum creatinine of at least 44 micromol/l within 48 h.


RESULTS
Of the 958 patients enrolled in the study, 147 (15%) were diabetic and 107 (11%) had stage III renal disease. The average baseline glomerular filtration rate was 88 +/- 25 ml/min/1.73 m(2). During the intervention an average of 238 +/- 86 ml of contrast medium was administered. CIN developed in 13 of 958 (1.4%; 95% confidence interval 0.6-2.1%) patients. The incidence of CIN was low even in predefined risk subgroups (women: 2.4%, diabetics: 2.7%, patients with stage III kidney disease: 6.5%).


CONCLUSIONS
The incidence of CIN is low when preprocedural fluid volume supplementation is used.
Mueller-Lenke
Nicole
N
University Hospital Basel, Basel, Switzerland.
Buerkle
Gerd
G
Klima
Theresia
T
Breidthardt
Tobias
T
Buettner
Heinz J
HJ
Mueller
Christian
C
D058186:Acute Kidney Injury / Q000139:chemically induced / Q000453:epidemiology* / Q000628:therapy; D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000379:methods; D001810:Blood Volume; D015331:Cohort Studies; D003287:Contrast Media / Q000009:adverse effects*; D005260:Female; D005919:Glomerular Filtration Rate / Q000187:drug effects; D006801:Humans; D015994:Incidence; D007479:Iopamidol / Q000009:adverse effects / Q000031:analogs & derivatives*; D007552:Isotonic Solutions / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D014882:Water-Electrolyte Balance
D003287:Contrast Media; D007552:Isotonic Solutions; C057937:iomeprol; D007479:Iopamidol