Department of Internal Medicine and Nephrology, Faculty of Medicine, Ain Shams University, Ramses Street 38, Abbasia, Cairo, 11566, Egypt.
Department of Cardiology, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
BMC Nephrol. 2023 Mar 22;24(1):65. doi: 10.1186/s12882-023-03114-4.
Contrast-induced acute kidney injury (CI-AKI) is known to be a complication of using intravascular contrast injection. Unfortunately, it is associated with adverse outcomes such as prolonged length of hospitalization and increased burden of health care costs. So, we aimed to determine the efficacy of febuxostat in the prevention of contrast-induced acute kidney injury among patients with chronic kidney disease Stage 3 performing percutaneous coronary intervention (PCI).
In a randomized controlled trial we enrolled 120 CKD stage 3 Patients with acute coronary syndrome referred to the cardiology department Ain-Shams University hospital for performing PCI and stenting. Patients were randomly assigned to two arms: Group I (study group): Included 60 patients who received Febuxostat added to the traditional treatment (IV hydration and N-acetylcysteine). The patients received Feburic 80 mg within 6-18 h before and within 6-18 h after the coronary intervention (a time gap of 24 h between two doses). Group II (control group): included 60 patients who received only traditional treatment.
The incidence of AKI was higher in the control group with a statistically significant difference. We found that Independent Significant risk factors that led to AKI were febuxostate avoidance, DM, high urea level, high creatinine level, CKD stage 3B, high Mehran score and high AKI risk.
We demonstrated that febuxostat has a Reno protective effect and it can help to reduce the incidence CI-AKI in CKD patients stage 3 performing PCI.
对比剂诱导的急性肾损伤(CI-AKI)是使用血管内对比剂注射已知的并发症。不幸的是,它与不良结局相关,如住院时间延长和医疗保健成本负担增加。因此,我们旨在确定别嘌醇在预防慢性肾脏病 3 期接受经皮冠状动脉介入治疗(PCI)的患者中对比剂诱导的急性肾损伤的疗效。
在一项随机对照试验中,我们招募了 120 名患有急性冠状动脉综合征的 CKD 3 期患者,这些患者被转诊到 Ain-Shams 大学医院心内科进行 PCI 和支架置入术。患者被随机分配到两组:I 组(研究组):包括 60 名接受别嘌醇联合传统治疗(静脉补液和 N-乙酰半胱氨酸)的患者。患者在冠状动脉介入治疗前 6-18 小时和治疗后 6-18 小时内接受 Feburic 80mg(两次剂量之间间隔 24 小时)。II 组(对照组):包括 60 名仅接受传统治疗的患者。
对照组 AKI 的发生率较高,差异有统计学意义。我们发现,导致 AKI 的独立显著危险因素是避免使用别嘌醇、DM、高尿素水平、高肌酐水平、CKD 3B 期、高 Mehran 评分和高 AKI 风险。
我们证明了别嘌醇具有肾保护作用,可帮助降低 CKD 患者 PCI 后 3 期 CI-AKI 的发生率。