Combined strategy of device-based contrast minimization and urine flow rate-guided hydration to prevent acute kidney injury in high-risk patients undergoing coronary interventional procedures

IF 2.1 3区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Catheterization and Cardiovascular Interventions Pub Date : 2024-09-19 DOI:10.1002/ccd.31229

Luca Paolucci MD, Francesca De Micco MD, Mario Scarpelli MD, Amelia Focaccio MD, Valeria Cavaliere MD, Carlo Briguori MD, PhD

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引用次数: 0

Abstract

Background and Aims

Contrast-associated acute kidney injury (CA-AKI) is a major complication following coronary procedures. We aimed to evaluate the effectiveness of a combination of urine flow rate-(UFR) guided hydration (RenalGuard^TM) and device-based contrast media (CM) reduction (DyeVert^TM) in CA-AKI prevention.

Methods

Stable high-risk patients undergoing coronary procedures with the use of DyeVert^TM and RenalGuard^TM were prospectively included (Combined group) and matched with a similar cohort of patients treated only with RenalGuard^TM in whom CM volume was controlled by operator-dependent strategies (Control group). CA-AKI was defined as a serum creatinine increase ≥0.3 mg/dL at 48 h.

Results

Overall, 55 patients were enrolled and matched with comparable controls. Patients in the Combined group were exposed to a lower CM dose (Control: 55 [30–90] mL vs. Combined: 42.1 [24.9–59.4] mL; p = 0.024). A significant interaction was found between treatment allocation and serum creatinine changes (p = 0.048). CA-AKI occurred in five (9.1%) patients in the Combined group and in 14 (25.4%) patients in the Control group (OR 0.29, 95% CI [0.09–0.88]).

Conclusions

A combined strategy of device-based CM reduction plus UFR-guided hydration is superior to operator-dependent CM sparing strategies plus UFR-guided hydration in preventing CA-AKI in high-risk patient.

查看原文本刊更多论文

基于设备的造影剂最小化和尿流率指导下的水合疗法相结合，预防冠状动脉介入手术高危患者的急性肾损伤

造影剂相关急性肾损伤（CA-AKI）是冠状动脉手术后的主要并发症。我们的目的是评估尿流率（UFR）引导下的水化（RenalGuardTM）和基于设备的造影剂（CM）减少（DyeVertTM）组合在预防 CA-AKI 方面的效果。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Catheterization and Cardiovascular Interventions 医学-心血管系统

CiteScore

5.40

自引率

8.70%

发文量

419

审稿时长

2 months

期刊介绍： Catheterization and Cardiovascular Interventions is an international journal covering the broad field of cardiovascular diseases. Subject material includes basic and clinical information that is derived from or related to invasive and interventional coronary or peripheral vascular techniques. The journal focuses on material that will be of immediate practical value to physicians providing patient care in the clinical laboratory setting. To accomplish this, the journal publishes Preliminary Reports and Work In Progress articles that complement the traditional Original Studies, Case Reports, and Comprehensive Reviews. Perspective and insight concerning controversial subjects and evolving technologies are provided regularly through Editorial Commentaries furnished by members of the Editorial Board and other experts. Articles are subject to double-blind peer review and complete editorial evaluation prior to any decision regarding acceptability.