title: Association between prophylactic hydration volume and risk of contrast-induced nephropathy after emergent percutaneous coronary intervention.
abstract: Intravenous hydration during percutaneous coronary intervention (PCI) significantly reduces the risk of contrast-induced nephropathy (CIN), but there are no well-defined protocols regard¬ing the optimal hydration volume (HV) required to prevent CIN following emergent PCI. Therefore, this study investigates the association between the intravenous HV and CIN after emergent PCI.
  
  
  
  711 patients were prospectively recruited who had underwent emergent PCI with hydration at routine speed and the relationship was investigated between HV or HV to weight ratio (HV/W) and the CIN risk, which was defined as a ≥ 25% or ≥ 0.5 mg/dL increase in serum creatinine levels from baseline within 48-72 h of exposure to the contrast.
  
  
  
  The overall CIN incidence was 24.7%. Patients in the higher HV quartiles had elevated CIN rates. Multivariate analysis showed that higher HV/W ratios were not associated with a decreased risk (using the HV) of CIN, but they were associated with an increased risk (using the HV/W) of CIN (Q4 vs. Q1: adjusted odds ratio 1.99; 95% confidence interval 1.05-3.74; p = 0.034). A higher HV/W ratio was not significantly associated with a reduced risk of long-term death (all p > 0.05).
  
  
  
  The data suggests that a higher total HV is not associated with a decreased CIN risk or beneficial long-term prognoses, and that excessive HV may increase the risk of CIN after emergent PCI.
authors.forename: Tongtao
authors.initials: T
authors.lastname: Cui
authors.forename: Jianbin
authors.initials: J
authors.lastname: Zhao
authors.forename: Weijie
authors.initials: W
authors.lastname: Bei
authors.forename: Hualong
authors.initials: H
authors.lastname: Li
authors.forename: Ning
authors.initials: N
authors.lastname: Tan
authors.forename: Dengxuan
authors.initials: D
authors.lastname: Wu
authors.forename: Kun
authors.initials: K
authors.lastname: Wang
authors.forename: Xiaosheng
authors.initials: X
authors.lastname: Guo
authors.forename: Yuanhui
authors.initials: Y
authors.lastname: Liu
authors.forename: Chongyang
authors.initials: C
authors.lastname: Duan
authors.forename: Shiqun
authors.initials: S
authors.lastname: Chen
authors.forename: Kaiyang
authors.initials: K
authors.lastname: Lin
authors.affiliation: Guangdong General Hospital, Guangdong Cardiovascular Institute, Guangdong Academy of Medical Sciences, Guangdong provincial Key Laboratory of Coronary Disease, School of Medicine, South China University of Technology. liuyongmd@126.com.
authors.forename: Yong
authors.initials: Y
authors.lastname: Liu
mesh_terms: D058186:Acute Kidney Injury / Q000139:chemically induced / Q000453:epidemiology / Q000628:therapy*; D002681:China / Q000453:epidemiology; D003287:Contrast Media / Q000009:adverse effects*; D017023:Coronary Angiography; D005260:Female; D005440:Fluid Therapy / Q000379:methods*; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D062645:Percutaneous Coronary Intervention / Q000379:methods*; D011379:Prognosis; D011446:Prospective Studies; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D000072657:ST Elevation Myocardial Infarction / Q000175:diagnosis / Q000601:surgery
chemical_list: D003287:Contrast Media
keywords: contrast-induced nephropathy; emergent percutaneous coronary intervention; hydration; prognoses