接受或未接受血管内治疗的外周血管造影患者中碘克沙醇与碘帕醇的肾毒性比较

Nephrotoxicity of iodixanol versus iopamidol in patients undergoing peripheral angiography with or without endovascular therapy.

作者信息

Xiong Hong-Liang, Peng Meng, Jiang Xiong-Jing, Dong Hui, Che Wu-Qiang, Chen Yang, Zou Yu-Bao, Xu Bo, Yang Yue-Jin, Gao Run-Lin

机构信息

Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 167, Beilishi Rd, Xicheng District, Beijing, 100037, China.

Department of Cardiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.

出版信息

Int Urol Nephrol. 2018 Oct;50(10):1879-1886. doi: 10.1007/s11255-018-1905-y. Epub 2018 Jun 13.

DOI:10.1007/s11255-018-1905-y

PMID:29948863

Abstract

PURPOSE

To compare the nephrotoxic effects of iodixanol and iopamidol in patients undergoing peripheral angiography.

METHODS

Patients scheduled for peripheral angiography were randomly assigned to the iodixanol group (n = 463) and iopamidol group (n = 458). The primary endpoint was the incidence of contrast associated acute kidney injury (CA-AKI), which was defined as an increase ≥ 25% or ≥ 44.2 µmol/l (0.5 mg/dl) in serum creatinine (SCr) from baseline within 72 h after receiving contrast media (CM). The secondary endpoints were the mean peak SCr increase within 72 h after receiving CM and major adverse renal events (SCr increased by two times after 30 days, the need for dialysis treatment, rehospitalization for acute renal failure, or kidney-related death) during hospitalization and within 30 day postdischarge.

RESULTS

The incidence of CA-AKI did not differ significantly between the iodixanol group and iopamidol group (18.1% vs. 16.8%; p = 0.595). There was no significant difference in the mean peak SCr increase between the iodixanol group and iopamidol group (10.4 ± 13.0 vs. 10.6 ± 14.3 µmol/l, p = 0.919). There were four patients [1 (0.2%) patient in the iodixanol group and 1 (0.7%) patients in the iopamidol group, p = 0.609] with doubling of SCr; no other adverse renal events were observed.

CONCLUSIONS

Our data showed that the nephrotoxicity of iodixanol was comparable with that of iopamidol in patients undergoing peripheral angiography.

摘要

目的

比较碘克沙醇和碘帕醇在接受外周血管造影术患者中的肾毒性作用。

方法

计划接受外周血管造影术的患者被随机分配至碘克沙醇组（n = 463）和碘帕醇组（n = 458）。主要终点为造影剂相关急性肾损伤（CA-AKI）的发生率，其定义为在接受造影剂（CM）后72小时内血清肌酐（SCr）较基线水平升高≥25%或≥44.2 μmol/l（0.5 mg/dl）。次要终点为接受CM后72小时内SCr平均峰值升高以及住院期间和出院后30天内的主要不良肾脏事件（30天后SCr升高两倍、需要透析治疗、因急性肾衰竭再次住院或肾脏相关死亡）。

结果

碘克沙醇组和碘帕醇组CA-AKI的发生率无显著差异（18.1%对16.8%；p = 0.595）。碘克沙醇组和碘帕醇组SCr平均峰值升高无显著差异（10.4±13.0对10.6±14.3 μmol/l，p = 0.919）。有4例患者[碘克沙醇组1例（0.2%），碘帕醇组1例（0.7%），p = 0.609]SCr升高两倍；未观察到其他不良肾脏事件。