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

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

来源：Cardiology Journal, 2017, 24(6): 660-670.

DOI：10.5603/CJ.a2017.0048

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

Background: Intravenous hydration during percutaneous coronary intervention (PCI) significantly reduces the risk of contrast-induced nephropathy (CIN), but there are no well-defined protocols regarding 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.

• 出版日期2017-12
• 单位广东省心血管病研究所; 南方医科大学; 广东省人民医院; 华南理工大学