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Ascorbic acid prevents contrast-mediated nephropathy in patients with renal dysfunction undergoing coronary

Konstantinos Spargias1, Elias Alexopoulos, Stamatis Kyrzopoulos

  • 1Department of Cardiology, Onassis Cardiac Surgery Centre, 356 Syngrou Ave, 176 74, Athens, Greece. spargias@ocsc.gr

Circulation
|October 20, 2004
PubMed

Insights

Oral ascorbic acid (vitamin C) may prevent kidney damage in patients undergoing coronary procedures. This antioxidant reduced the incidence of contrast-mediated nephropathy in a randomized trial, suggesting a protective effect against contrast-induced kidney injury.

Area of Science:

  • Nephrology
  • Cardiology
  • Pharmacology

Background:

  • Contrast agents can induce renal dysfunction via reactive oxygen species.
  • Acetylcysteine has shown potential in preventing contrast-induced nephropathy, but other antioxidants remain uninvestigated.

Purpose of the Study:

  • To evaluate the efficacy of ascorbic acid as a prophylactic agent against contrast-mediated nephropathy in patients undergoing coronary angiography or intervention.

Main Methods:

  • A randomized, double-blind, placebo-controlled trial involving 231 high-risk patients (serum creatinine > or =1.2 mg/dL).
  • Patients received either oral ascorbic acid (3g pre-procedure, 2g post-procedure) or a placebo.
  • Contrast-mediated nephropathy was defined as an increase in serum creatinine > or =0.5 mg/dL or > or =25% within 2-5 days post-procedure.

Main Results:

  • Contrast-mediated nephropathy occurred in 9% of patients receiving ascorbic acid versus 20% in the placebo group (OR, 0.38; P=0.02).
  • The mean increase in serum creatinine was significantly greater in the placebo group compared to the ascorbic acid group (P=0.049).

Conclusions:

  • Prophylactic oral ascorbic acid administration may offer protection against contrast-mediated nephropathy in high-risk patients undergoing coronary procedures.
  • Ascorbic acid represents a potential therapeutic strategy to mitigate contrast-induced kidney injury.
Abstract

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