Shojaei Lida, Esfandiary Shima, Rouzbahani Mohammad, Heydarpour Fatemeh, Bahremand Mostafa, Heidary Moghadam Reza, Mahmoudi Ghazal, Korani Farzaneh, Raissi Farshid, Shahbazi Foroud
Department of Clinical Pharmacy, Faculty of Pharmacy, Kermanshah University of Medical Sciences, Kermanshah, Iran.
Clinical Research Development Center, Imam Ali and Taleghani Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran.
Iran J Pharm Res. 2022 Jun 14;21(1):e126920. doi: 10.5812/ijpr-126920. eCollection 2022 Dec.
Contrast-induced nephropathy (CIN) is the third cause of hospital-acquired acute kidney injury. The CIN prophylactic strategies adopted to date, although not highly efficient, are mostly based on antioxidant activity and hydration therapy. This study was designed and conducted to evaluate crocin's efficacy in the prevention of CIN in chronic kidney disease (CKD) patients undergoing coronary angiography/angioplasty. In this randomized clinical trial, a total of 110 eligible CKD stage 3 patients requiring contrast agent administration for coronary angiography/angioplasty were enrolled and randomly assigned to either crocin (n = 57) or control (n = 53) group. The patients in both groups received standard hydration therapy; nevertheless, in the crocin group, the patients were also orally administered three consecutive oral doses of 30 mg crocin tablets 1 day before up to 1 day after contrast media (CM) exposure. The primary endpoint was CIN incidence defined as an increase in serum creatinine (SrCr) level by ≥ 0.3 mg/dL or any change in urinary neutrophil gelatinase-associated lipocalin (NGAL) from the baseline within 48 hours of CM exposure. During 4 months, 130 patients were recruited. The mean age of the patients was 65.62 ± 9.05 years, and the majority of them were male (64.54%). The SrCr in the crocin group did not significantly increase within 48 hours of angiography/angioplasty. The changes in the urinary NGAL level were not significant in both groups. The CIN incidence was significantly lower in the crocin group than in the control group (1.75% and 13.2%; P = 0.028). Crocin administration plays an important nephron-protective role in the prevention of CIN.
造影剂肾病（CIN）是医院获得性急性肾损伤的第三大病因。迄今为止所采用的CIN预防策略，尽管效率不高，但大多基于抗氧化活性和水化治疗。本研究旨在评估藏红花素对接受冠状动脉造影/血管成形术的慢性肾脏病（CKD）患者预防CIN的疗效。在这项随机临床试验中，总共纳入了110例符合条件的3期CKD患者，这些患者因冠状动脉造影/血管成形术需要使用造影剂，并被随机分为藏红花素组（n = 57）或对照组（n = 53）。两组患者均接受标准水化治疗；然而，在藏红花素组中，患者在造影剂（CM）暴露前1天至暴露后1天还连续口服3剂30 mg藏红花素片。主要终点是CIN发生率，定义为血清肌酐（SrCr）水平升高≥0.3 mg/dL，或在CM暴露后48小时内尿中性粒细胞明胶酶相关脂质运载蛋白（NGAL）相对于基线有任何变化。在4个月期间，招募了130例患者。患者的平均年龄为65.62±9.05岁，其中大多数为男性（64.54%）。藏红花素组在冠状动脉造影/血管成形术后48小时内SrCr没有显著升高。两组尿NGAL水平的变化均不显著。藏红花素组的CIN发生率显著低于对照组（1.75%和13.2%；P = 0.028）。服用藏红花素在预防CIN方面发挥着重要的肾单位保护作用。
