Interv Akut Kardiol. 2008;7(2):50-53

Contrast-induced nephropathy prevention in elderly patients with chronic kidney disease

Jan Matějka¹, Ivo Varvařovský², Petr Vojtíšek¹, Aleš Herman², Vladimír Rozsíval², Jiří Kvasnička¹

¹ Kardiologické oddělení Krajské nemocnice Pardubice

² Kardio-Troll, pracoviště invazivní kardiologie, Krajská nemocnice, Pardubice

Purpose of the trial: To test effectiveness of theophylline in contrast-induced nephropathy (CIN) prevention in well hydrated population.

Methods: A randomized, double-blind, placebo-controlled trial. 56 patients undergoing coronary angiography (CAG) and/or percutaneous coronary intervention (PCI) were enrolled, 31 to theophylline group (200 mg IV before procedure) and 25 to placebo group. The primary endpoint was increase in serum creatinine from baseline to study termination 48 hours after CAG. Iso-osmolar contrast iodixanol was used.

Results: Demographics are similar in both placebo and theophylline groups: estimated glomerular filtration rate (33 ± 10 vs. 33 ± 10 ml/min/1.73m2; p = 0.87), diabetes mellitus (80 % vs. 71 %; p = 0.44), amount of contrast used (94 ± 35 vs. 95 ± 38 ml; p = 0.89). Serum creatinine did not increase 48 hours after CAG and/or PCI (180 ± 45 vs. 184 ± 53 μmol/l; p = 0.67). There was no difference between two treatment groups neither at baseline (182 ± 52 vs. 179 ± 40 μmol/l; p = 0.62) nor at study termination (182 ± 60 vs. 186 ± 47 μmol/l; p = 0.79). CIN occurred in 5.4 % patients.

Conclusions: Low CIN incidence was achieved using parenteral hydratation and minimum necessary amount of contrast. Prophylactic effect of theophylline was not observed.

Keywords: contrast media, chronic kidney disease, angioplasty, coronary angiography, theophylline

Published: June 1, 2008  Show citation