title: Efficacy of nicorandil treatment for prevention of contrast-induced nephropathy in high-risk patients undergoing cardiac catheterization: A prospective randomized controlled trial.
abstract: BACKGROUND
  Contrast-induced nephropathy (CIN) remains to be a potentially serious complication of radiographic procedures and is the third leading cause of the acute kidney injury (AKI) among hospitalized patients. This clinical trial was performed to assess the preventive effect of oral nicorandil on CIN in high-risk patients undergoing cardiac catheterization.
  
  
  METHODS
  In this prospective, randomized, controlled trial, 128 patients with at least two risk factors for CIN undergoing elective percutaneous coronary intervention (PCI) were randomly assigned to either the nicorandil group or the control group. Patients in the nicorandil group (n = 64) received 10 mg nicorandil, daily from 30 min before and up to 3 days after procedure and intravenous hydration for 2 h before and 6 h after the procedure, whereas patients in the control group (n = 64) just received intravenous hydration. Serum creatinine (SCr) was measured before contrast exposure and at 72 h. CIN was defined as an increase of 25% in SCr or > 0.5 mg/dL 72 h after contrast administration.
  
  
  RESULTS
  Contrast-induced nephropathy occurred in 14 out of 64 (21.9%) patients in the control group and in 3 out of 64 (4.7%) patients in the nicorandil group. There was a significant difference in the incidence of CIN between the two groups at 72 h after administering the radiocontrast agent (p = 0.008). Moreover, there were significant differences between the two groups in SCr and estimated glomerular filtration rate 72 h after radiocontrast administration (p < 0.05).
  
  
  CONCLUSIONS
  The findings revealed that oral nicorandil had substantial efficacy over hydration protocol for the development of CIN in high-risk patients undergoing cardiac catheterization.
authors.forename: Leili
authors.initials: L
authors.lastname: Iranirad
authors.forename: Seyed Fakhreddin
authors.initials: SF
authors.lastname: Hejazi
authors.affiliation: Student Research Committee, Qom University of Medical Sciences, Qom, Iran, Islamic Republic Of; School of Medicine, Zahedan University of Medical Sciences, Zahedan, Iran, Islamic Republic Of. salehsadeghi87@gmail.com.
authors.forename: Mohammad Saleh
authors.initials: MS
authors.lastname: Sadeghi
authors.forename: Shahram Arsang
authors.initials: SA
authors.lastname: Jang
mesh_terms: D058186:Acute Kidney Injury / Q000139:chemically induced / Q000175:diagnosis / Q000503:physiopathology / Q000517:prevention & control*; D000284:Administration, Oral; D000368:Aged; D006328:Cardiac Catheterization / Q000009:adverse effects*; D003287:Contrast Media / Q000008:administration & dosage / Q000009:adverse effects*; D017023:Coronary Angiography / Q000009:adverse effects*; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000628:therapy*; D005260:Female; D005440:Fluid Therapy; D005919:Glomerular Filtration Rate / Q000187:drug effects; D006801:Humans; D007492:Iran; D007668:Kidney / Q000187:drug effects* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D020108:Nicorandil / Q000008:administration & dosage* / Q000009:adverse effects; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects*; D011446:Prospective Studies; D012076:Renal Agents / Q000008:administration & dosage* / Q000009:adverse effects; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D003287:Contrast Media; D012076:Renal Agents; D020108:Nicorandil
keywords: contrast-induced nephropathy; nicorandil; percutaneous coronary intervention