title: Efficacy of allopurinol pretreatment for prevention of contrast-induced nephropathy: a randomized controlled trial.
abstract: BACKGROUND
  Contrast-induced nephropathy (CIN) remains a common complication of radiographic procedures. Radiocontrast agents can cause a reduction in renal function that may be due to reactive oxygen species. Conflicting evidence suggests that administration of antioxidants prevents CIN.
  
  
  METHODS
  We assessed the efficacy of allopurinol in preventing CIN. We prospectively randomized 159 patients with a serum creatinine concentration >1.1mg/dL undergoing cardiac catheterization/interventions to receive allopurinol (300 mg, p.o.) 24h before administration of radiocontrast agent and hydration (1mg/kg/hN/saline for 12h pre- and post-contrast, n=79), or hydration alone (1mg/kg/hN/saline for 12h pre- and post-contrast, n=80).
  
  
  RESULTS
  CIN occurred in 6 of 80 patients (7.5%) in the control group and no subjects in the allopurinol group (p=0.013). In the allopurinol group, median serum creatinine concentration decreased significantly from 1.43 mg/dL [1.1-4.15 mg/dL] to 1.35 mg/dL [0.7-4.15 mg/dl] at 48 h and to 1.27 mg/dL [0.66-4.37 mg/dL] at 4 days after radiocontrast administration (p<0.0001 and p<0.0001 compared with baseline, respectively). In the control group, median serum creatinine concentration decreased non-significantly from 1.48 mg/dL [1.1-2.96 mg/dL] to 1.43 mg/dL [0.73-3.02 mg/dL] and to 1.45 mg/dL [0.86-3.71 mg/dL] (p=0.045 and p=0.57, respectively) 48 h and 4 days after radiocontrast administration.
  
  
  CONCLUSIONS
  Prophylactic oral administration of allopurinol, along with hydration, may protect against CIN in high-risk patients undergoing coronary procedures.
authors.affiliation: Baskent University Faculty of Medicine, Department of Cardiology, Adana, Turkey. tanselerol@yahoo.com
authors.forename: T
authors.initials: T
authors.lastname: Erol
authors.forename: A
authors.initials: A
authors.lastname: Tekin
authors.forename: M T
authors.initials: MT
authors.lastname: Katırcıbaşı
authors.forename: N
authors.initials: N
authors.lastname: Sezgin
authors.forename: M
authors.initials: M
authors.lastname: Bilgi
authors.forename: G
authors.initials: G
authors.lastname: Tekin
authors.forename: A
authors.initials: A
authors.lastname: Zümrütdal
authors.forename: A T
authors.initials: AT
authors.lastname: Sezgin
authors.forename: H
authors.initials: H
authors.lastname: Müderrisoğlu
mesh_terms: D058186:Acute Kidney Injury / Q000139:chemically induced* / Q000378:metabolism / Q000517:prevention & control*; D000368:Aged; D000493:Allopurinol / Q000008:administration & dosage*; D003287:Contrast Media / Q000009:adverse effects*; D005260:Female; D005440:Fluid Therapy / Q000379:methods*; D016166:Free Radical Scavengers / Q000008:administration & dosage*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D016896:Treatment Outcome
chemical_list: D003287:Contrast Media; D016166:Free Radical Scavengers; D000493:Allopurinol