open access

Vol 24, No 6 (2017)
Original articles — Clinical cardiology
Published online: 2017-04-10
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Association between prophylactic hydration volume and risk of contrast-induced nephropathy after emergent percutaneous coronary intervention

Tongtao Cui, Jianbin Zhao, Weijie Bei, Hualong Li, Ning Tan, Dengxuan Wu, Kun Wang, Xiaosheng Guo, Yuanhui Liu, Chongyang Duan, Shiqun Chen, Kaiyang Lin, Yong Liu
DOI: 10.5603/CJ.a2017.0048
·
Pubmed: 28394010
·
Cardiol J 2017;24(6):660-670.

open access

Vol 24, No 6 (2017)
Original articles — Clinical cardiology
Published online: 2017-04-10

Abstract

Background: 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. Methods: 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. Results: 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). Conclusions: 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.

Abstract

Background: 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. Methods: 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. Results: 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). Conclusions: 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.
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Keywords

contrast-induced nephropathy, hydration, emergent percutaneous coronary intervention, prognoses

About this article
Title

Association between prophylactic hydration volume and risk of contrast-induced nephropathy after emergent percutaneous coronary intervention

Journal

Cardiology Journal

Issue

Vol 24, No 6 (2017)

Pages

660-670

Published online

2017-04-10

DOI

10.5603/CJ.a2017.0048

Pubmed

28394010

Bibliographic record

Cardiol J 2017;24(6):660-670.

Keywords

contrast-induced nephropathy
hydration
emergent percutaneous coronary intervention
prognoses

Authors

Tongtao Cui
Jianbin Zhao
Weijie Bei
Hualong Li
Ning Tan
Dengxuan Wu
Kun Wang
Xiaosheng Guo
Yuanhui Liu
Chongyang Duan
Shiqun Chen
Kaiyang Lin
Yong Liu

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