Mueller-Lenke Nicole, Buerkle Gerd, Klima Theresia, Breidthardt Tobias, Buettner Heinz J, Mueller Christian
University Hospital Basel, Basel, Switzerland.
Med Princ Pract. 2008;17(5):409-14. doi: 10.1159/000141507. Epub 2008 Aug 6.
The present study was performed to determine the effect of combined intravenous and oral volume supplementation on the incidence of contrast-induced nephropathy (CIN) in patients undergoing percutaneous coronary intervention (PCI).
Consecutive patients (n = 958) receiving iomeprol 350 during PCI were evaluated prospectively for the development of CIN. All patients received protocol-defined intravenous and oral volume supplementation. CIN was defined as an increase in serum creatinine of at least 44 micromol/l within 48 h.
Of the 958 patients enrolled in the study, 147 (15%) were diabetic and 107 (11%) had stage III renal disease. The average baseline glomerular filtration rate was 88 +/- 25 ml/min/1.73 m(2). During the intervention an average of 238 +/- 86 ml of contrast medium was administered. CIN developed in 13 of 958 (1.4%; 95% confidence interval 0.6-2.1%) patients. The incidence of CIN was low even in predefined risk subgroups (women: 2.4%, diabetics: 2.7%, patients with stage III kidney disease: 6.5%).
The incidence of CIN is low when preprocedural fluid volume supplementation is used.
本研究旨在确定经皮冠状动脉介入治疗（PCI）患者中静脉和口服联合补液对造影剂肾病（CIN）发生率的影响。
前瞻性评估连续958例在PCI期间接受碘美普尔350的患者发生CIN的情况。所有患者均接受方案规定的静脉和口服补液。CIN定义为48小时内血清肌酐至少升高44微摩尔/升。
在纳入研究的958例患者中，147例（15%）患有糖尿病，107例（11%）患有III期肾病。平均基线肾小球滤过率为88±25毫升/分钟/1.73平方米。介入治疗期间平均使用造影剂238±86毫升。958例患者中有13例（1.4%；95%置信区间0.6 - 2.1%）发生CIN。即使在预先定义的风险亚组中，CIN的发生率也较低（女性：2.4%，糖尿病患者：2.7%，III期肾病患者：6.5%）。
术前进行补液时，CIN的发生率较低。
