The role of theophylline in prevention of radiocontrast media-induced nephropathy.
Contrast media induced nephropathy (CIN) results in significant morbidity and mortality. We therefore investigated whether theophylline (adenosine antagonist) reduces the incidence of contrast media induced nephropathy. Two hundred and eighty patients were randomly assigned to prophylactic administration of hydration with sodium bicarbonate plus theophylline (either orally or intravenously) (n=128) or hydration with sodium bicarbonate only (n=152). Blood Urea, creatinine, and glomerular filtration rate (MDRD) were measured before and after administration of contrast media. Both groups were similar in clinical characteristics and amount of contrast used. Theophylline prophylaxis significantly reduced the incidence of CIN (1.6% vs 7.9%; P= 0.015). Compared to low-risk patients, Theophylline prophylaxis significantly reduced the incidence of CIN in moderate and high-risk patients (0% vs 8.8%; P= 0.022 and 9.1% vs 42.1%; P= 0.014 respectively). In conclusion, prophylactic administration of theophylline reduces the incidence of CIN in moderate and high-risk patients for CIN.
Department of Internal Medicine, Aleppo University Hospitals, Syrian Arab Republic.
Mahmoud
M
Malhis
Sami
S
Al-Bitar
Khair
K
Al-Deen Zaiat
D000241:Adenosine / Q000037:antagonists & inhibitors* / Q000378:metabolism; D000284:Administration, Oral; D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D003287:Contrast Media / Q000009:adverse effects*; D003404:Creatinine / Q000097:blood; D005260:Female; D005919:Glomerular Filtration Rate / Q000187:drug effects; D006801:Humans; D015994:Incidence; D007262:Infusions, Intravenous; D007668:Kidney / Q000187:drug effects* / Q000378:metabolism; D007674:Kidney Diseases / Q000139:chemically induced / Q000453:epidemiology / Q000378:metabolism / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D020011:Protective Agents / Q000008:administration & dosage*; D018570:Risk Assessment; D012307:Risk Factors; D017693:Sodium Bicarbonate / Q000008:administration & dosage; D013593:Syria / Q000453:epidemiology; D013806:Theophylline / Q000008:administration & dosage*; D016896:Treatment Outcome; D014508:Urea / Q000097:blood
D015415:Biomarkers; D003287:Contrast Media; D020011:Protective Agents; D017693:Sodium Bicarbonate; D014508:Urea; D003404:Creatinine; D013806:Theophylline; D000241:Adenosine