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Renal protection for coronary angiography in advanced renal failure patients by prophylactic hemodialysis. A

Po-Tsang Lee1, Kang-Ju Chou, Chun-Peng Liu

  • 1Division of Nephrology, Department of Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.

Journal of the American College of Cardiology
|September 11, 2007
PubMed

Insights

Prophylactic hemodialysis significantly improves kidney outcomes for patients with advanced renal failure undergoing coronary angiography. This intervention reduces the risk of contrast nephropathy (CN) and the need for dialysis.

Area of Science:

  • Nephrology
  • Cardiology
  • Radiology

Background:

  • Pre-existing renal failure is a major risk factor for contrast nephropathy (CN).
  • The efficacy of hemodialysis in preventing CN remains uncertain, despite its ability to remove contrast media.

Purpose of the Study:

  • To investigate whether prophylactic hemodialysis reduces contrast nephropathy (CN) in patients with advanced renal failure undergoing coronary angiography.

Main Methods:

  • Eighty-two patients with chronic renal failure were randomized into two groups: a dialysis group (n=42) receiving intravenous normal saline and prophylactic hemodialysis, and a control group (n=40) receiving fluid supplement only.
  • Renal function was assessed by monitoring creatinine clearance and serum creatinine concentrations.

Main Results:

  • Prophylactic hemodialysis significantly lessened the decrease in creatinine clearance within 72 hours post-procedure.
  • The dialysis group exhibited significantly lower serum creatinine concentrations at day 4 and peak levels compared to the control group.
  • Fewer patients in the dialysis group required temporary renal replacement therapy (2% vs. 35%) or long-term dialysis (0% vs. 13%) after discharge.

Conclusions:

  • Prophylactic hemodialysis is an effective strategy for improving renal outcomes in patients with chronic renal failure undergoing coronary angiography.
  • This intervention demonstrates a significant reduction in contrast nephropathy and the need for renal replacement therapy.
Abstract

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