Efficacy of oral hydration in the prevention of contrast-induced acute kidney injury in patients undergoing coronary angiography or intervention.
BACKGROUND
Efficacy of intravenous (IV) volume expansion in preventing contrast-induced acute kidney injury (CI-AKI) is well known. However, the role of oral hydration has not been well established. The aim of this work was to evaluate the efficacy of oral hydration in preventing CI-AKI.


METHODS
We prospectively randomized 225 patients undergoing coronary angiography and/or percutaneous coronary intervention in either oral hydration or IV hydration groups. Patients who have at least one of the high-risk factors for developing CI-AKI (advanced age, type 2 diabetes mellitus, anemia, hyperuricemia, a history of cardiac failure or systolic dysfunction) were included in the study. All patients had normal renal function or stage 1-2 chronic kidney disease. Patients in the oral hydration group were encouraged to drink unrestricted amounts of fluids freely whereas isotonic saline infusion was performed by the standard protocol in the IV hydration group.


RESULTS
CI-AKI occurred in 8/116 patients (6.9%) in the oral hydration group and 8/109 patients (7.3%) in the IV hydration group (p = 0.89). There was also no statistically significant difference between the two groups when different CI-AKI definitions were taken into account.


CONCLUSIONS
Oral hydration is as effective as IV hydration in preventing CI-AKI in patients with normal kidney function or stage 1-2 chronic kidney disease, and who also have at least one of the other high-risk factors for developing CI-AKI.
Department of Cardiology, Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey.
Sukru
S
Akyuz
Mehmet
M
Karaca
Tugba
T
Kemaloglu Oz
Servet
S
Altay
Baris
B
Gungor
Baris
B
Yaylak
Selcuk
S
Yazici
Kivilcim
K
Ozden
Gultekin
G
Karakus
Nese
N
Cam
D058186:Acute Kidney Injury / Q000139:chemically induced* / Q000517:prevention & control*; D000284:Administration, Oral; D000368:Aged; D000369:Aged, 80 and over; D003287:Contrast Media / Q000009:adverse effects*; D017023:Coronary Angiography; D004326:Drinking; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D062645:Percutaneous Coronary Intervention; D011446:Prospective Studies; D051436:Renal Insufficiency, Chronic; D016037:Single-Blind Method; D012965:Sodium Chloride / Q000008:administration & dosage
D003287:Contrast Media; D012965:Sodium Chloride