title: Importance of oral fluid intake after coronary computed tomography angiography: an observational study.
abstract: BACKGROUND
  The prevention of contrast-induced acute kidney injury (AKI) after coronary computed tomography angiography (CCTA) is important because patients referred for CCTA often need further contrast exposure such as an invasive coronary angiography. We aimed to examine the effects of oral volume intake on renal function in patients with preserved renal function referred for CCTA.
  
  
  METHODS
  We enrolled 180 patients who were referred for CCTA. The serum creatinine (SCr) and estimated glomerular filtration rate (eGFR) levels were measured before, 24h, and a mean of 4.8 days after CCTA. The amount of unrestricted oral fluid intake for 24h was checked. The patients were divided into two groups: 106 subjects with a rise in SCr after CCTA (group A); and 74 without (group B).
  
  
  RESULTS
  Significant correlations were observed between the amount of oral fluid intake and the percentage changes in SCr (%SCr) (r=-0.66, p<0.0001) as well as the absolute changes in eGFR (ΔeGFR) (r=0.65, p<0.0001). The percentage of patients showing hemoglobin-A1c (HbA1c)≥6.5% was greater in group A than in group B (29% vs. 18%, p<0.001). Patients with HbA1c≥6.5% showed higher %SCr and lower ΔeGFR compared to those without it. Multiple regression analysis revealed that the amount of oral fluid intake was the only independent predictor for a rise in SCr (β=-0.731, p<0.0001).
  
  
  CONCLUSIONS
  Oral volume intake after CCTA is a very simple but important prophylactic procedure for contrast-induced AKI especially in diabetic patients.
authors.affiliation: Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors.forename: Daiji
authors.initials: D
authors.lastname: Yoshikawa
authors.forename: Satoshi
authors.initials: S
authors.lastname: Isobe
authors.forename: Kimihide
authors.initials: K
authors.lastname: Sato
authors.forename: Toshio
authors.initials: T
authors.lastname: Ohashi
authors.forename: Yuka
authors.initials: Y
authors.lastname: Fujiwara
authors.forename: Hisato
authors.initials: H
authors.lastname: Ohyama
authors.forename: Hideki
authors.initials: H
authors.lastname: Ishii
authors.forename: Toyoaki
authors.initials: T
authors.lastname: Murohara
mesh_terms: D058186:Acute Kidney Injury / Q000453:epidemiology* / Q000517:prevention & control*; D000284:Administration, Oral; D000368:Aged; D003287:Contrast Media; D017023:Coronary Angiography / Q000706:statistics & numerical data*; D064420:Drug-Related Side Effects and Adverse Reactions / Q000453:epidemiology / Q000517:prevention & control; D005260:Female; D005440:Fluid Therapy / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D008297:Male; D018570:Risk Assessment; D012307:Risk Factors; D014057:Tomography, X-Ray Computed / Q000706:statistics & numerical data*; D016896:Treatment Outcome; D014283:Triiodobenzoic Acids
chemical_list: D003287:Contrast Media; D014283:Triiodobenzoic Acids; C054871:ioversol