2nd Department of Cardiology, The Mikołaj Kopernik University in Toruń, Collegium Medicum, Bydgoszcz, Poland.
Kardiol Pol. 2010 Sep;68(9):1015-20.
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.
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.
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.
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).
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.
对比剂肾病（CIN）是经皮冠状动脉介入治疗（PCI）的严重并发症。适当水化可降低 PCI 的风险。口服水化与静脉水化的效果是否相当尚未得到充分证实。
确定在接受冠状动脉造影和血管成形术的糖尿病患者中，矿泉水口服水化与等渗溶液（0.9%NaCl）静脉水化对肾功能的影响。
该研究纳入了 102 名患者（年龄 67 ± 7.8 岁，44 名女性/58 名男性）。符合条件的患者（第 1 组-52 例）在 PCI 前 6 小时至后 12 小时内静脉内（1mL/kg/h）输注等渗溶液（0.9%NaCl）。50 名患者（第 2 组）被随机分为在血管造影或血管成形术前 6-12 小时内口服矿泉水（1mL/kg/h）并在术后 12 小时内接受相同的水化治疗。所有患者在检查过程中均接受碘海醇造影剂。研究的主要终点是评估造影剂给药前后 72 小时的肾功能。
第 1 组患者的基础肌酐清除率为 70.3 ± 21.22mL/min，第 2 组为 78.69 ± 19.92mL/min（无统计学差异）。第 1 组患者的造影剂平均用量为 101.1 ± 36.7mL，第 2 组为 110.4 ± 45.3mL（无统计学差异）。术后 72 小时，第 1 组患者的肌酐清除率为 65.3 ± 23.39mL/min，第 2 组为 73.5 ± 21.94mL/min（无统计学差异）。
本研究表明，在接受冠状动脉造影和血管成形术的糖尿病患者中，矿泉水口服水化与 0.9%NaCl 静脉水化对肾功能的影响相似。
