title: Preventing acute decrease in renal function induced by coronary angiography (PRECORD): a prospective randomized trial.
abstract: BACKGROUND
  Infusion of saline attenuates the decrease in renal function induced by radiographic contrast agents among patients with chronic renal insufficiency.
  
  
  OBJECTIVE
  The Preventing Renal alteration in Coronary Disease (PRECORD) trial was a randomized trial to assess the effect on renal function of saline infusion during and after coronary angiography in 201 patients without severe chronic renal insufficiency (serum creatinine<140micromol/L).
  
  
  METHODS
  All patients received standard oral hydration: 2000mL of tap water within the 24 hours after coronary angiography. Patients were randomized before the procedure to intravenous hydration (1000mL of 0.9% saline infusion) or no additional hydration. The infusion was started in the catheterization laboratory and continued for 24 hours. The primary endpoint was the change in calculated creatinine clearance between baseline and 24 hours after coronary angiography. The same ionic low osmolar radiographic contrast agent (ioxaglate) was used in all patients.
  
  
  RESULTS
  Both groups had similar baseline characteristics, including age, serum creatinine, volume of contrast and proportion of patients undergoing ad hoc coronary angioplasty. The overall decrease in serum creatinine clearance 24 hours after the procedure was -3.44 (0.68)mL/min. The change in serum creatinine clearance 24 hours after the procedure was -2.81 (1.07)mL/min in the infusion group vs -4.09 (0.91)mL/min in the control group (p=0.38).
  
  
  CONCLUSIONS
  Renal function is altered only slightly 24 hours after coronary angiography with standard oral hydration alone and is not affected by saline infusion started at the beginning of coronary angiography, even in patients with mild-to-moderate renal dysfunction.
authors: Service de cardiologie D, hôpital cardiovasculaire et pneumologique Louis-Pradel, groupement hospitalier Est, université Claude-Bernard Lyon-1, avenue Doyen-Lepine, Bron cedex, France.
authors: Denis
authors: D
authors: Angoulvant
authors: Michel
authors: M
authors: Cucherat
authors: Gilles
authors: G
authors: Rioufol
authors: Gérard
authors: G
authors: Finet
authors: Jacques
authors: J
authors: Beaune
authors: Didier
authors: D
authors: Revel
authors: Maurice
authors: M
authors: Laville
authors: Michel
authors: M
authors: Ovize
authors: Xavier
authors: X
authors: André-Fouët
mesh_terms: D000208:Acute Disease; D015415:Biomarkers / Q000097:blood; D003287:Contrast Media / Q000009:adverse effects*; D017023:Coronary Angiography / Q000009:adverse effects*; D003404:Creatinine / Q000097:blood; D005260:Female; D005440:Fluid Therapy; D006801:Humans; D007262:Infusions, Intravenous; D007485:Ioxaglic Acid / Q000009:adverse effects*; D007674:Kidney Diseases / Q000097:blood / Q000209:etiology / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012965:Sodium Chloride / Q000008:administration & dosage*; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D003287:Contrast Media; D012965:Sodium Chloride; D003404:Creatinine; D007485:Ioxaglic Acid