Oral versus intravenous hydration and renal function in diabetic patients undergoing percutaneous coronary interventions

Abstract

Background: Contrast-induced nephropathy (CIN) is a serious complication of percutenous coronary interventions (PCI). Proper hydration reduces the risk of PCI. Wheter oral hydration is as effective as intravenous one has not been well established.
Aim: To determine the effects of oral hydration with mineral water versus intravenous hydration with isotonic solution (0.9% NaCl) on renal function in diabetic patients undergoing coronary angiography and angioplasty.
Methods: The study included 102 patients (age 67 ± 7.8 years, 44 female/58 male). Eligible patients (group 1 - 52 pts) were hydrated intravenously (1 mL/kg/h) 6 hours before and during 12 hours following PCI with isotonic solution (0.9% NaCl). Fifty patients (group 2) were randomised to receive oral mineral water (1 mL/kg/h) 6-12 hours before and during 12 hours following angiography or angioplasty. All patients during the procedure received contrast medium ioversol. Primary endpoint of the study was the evaluation of renal function before and 72 hours after contrast medium administration.
Results: Baseline creatinine clearance was 70.3 ± 21.22 mL/min in group 1 and 78.69 ± 19.92 mL/min in group 2 (NS). The mean volume of contrast medium was 101.1 ± 36.7 mL in group 1 and 110.4 ± 45.3 mL in group 2 (NS). At 72 hours after the procedure, creatinine clearance was 65.3 ± 23.39 mL/min in group 1 and 73.5 ± 21.94 mL/min in group 2 (NS).
Conclusions: Our study demonstrates that the oral hydration with mineral water and intravenous hydration with 0.9% NaCl have similar effects on renal function in diabetic patients undergoing coronary angiography and angioplasty.
Kardiol Pol 2010; 68, 9: 1015-1020