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Preventive effect of reduced glutathione on contrast-induced nephropathy in elderly patients undergoing coronary
1Department of Cardiology, Huashan Hospital, Fudan University, Shanghai, CN.
Insights
Reduced glutathione did not prevent contrast-induced nephropathy (CIN) in elderly patients undergoing coronary angiography. Hydration with reduced glutathione showed no significant benefit over hydration alone for CIN prevention in this high-risk population.
Area of Science:
- Nephrology
- Cardiology
- Geriatrics
Background:
- Coronary angiography poses a risk for contrast-induced nephropathy (CIN) in elderly patients.
- Reduced glutathione is a potential agent for preventing CIN through various mechanisms.
Purpose of the Study:
- To prospectively evaluate if hydration with reduced glutathione is superior to hydration alone in preventing CIN.
- To assess the efficacy of reduced glutathione in an elderly Han Chinese population undergoing coronary angiography.
Main Methods:
- A prospective study involving 505 elderly patients (≥75 years) undergoing coronary angiography or intervention.
- Patients were randomized into two groups: hydration with reduced glutathione (n=262) or hydration alone (n=243).
- Serum creatinine and blood urea nitrogen were measured pre-procedure and 48 hours post-procedure to determine CIN incidence.
Main Results:
- The overall incidence of CIN was 6.49% in the reduced glutathione group and 7.41% in the control group (P=0.68).
- No significant difference in CIN incidence was observed between the groups.
- Subgroup analysis for percutaneous coronary intervention also showed no significant difference.
Conclusions:
- Reduced glutathione, when added to optimal hydration, does not offer additional protection against CIN in elderly patients undergoing coronary angiography or intervention.
- Current evidence does not support the routine use of reduced glutathione for CIN prevention in this patient demographic.
Abstract:
Coronary angiography can be a high-risk condition for the incidence of contrast-induced nephropathy (CIN) in elderly patients. Reduced glutathione, under a variety of mechanisms, may prevent CIN in this procedure. We prospectively examined whether hydration with reduced glutathione is superior to hydration alone for prevention of CIN in an elderly Han Chinese population. A total of 505 patients (271 males and 234 females) aged 75 years or older who underwent non-emergency coronary angiography or an intervention were randomly divided into two groups. The treatment group received hydration with reduced glutathione (n=262) and the control group received hydration alone (n=243). Serum creatinine and blood urea nitrogen levels were measured prior to coronary angiography and 48 h after this procedure. The primary endpoint was occurrence of CIN, which was defined as 25% or 44.2 µmol/L above baseline serum creatinine levels 48 h after the procedure. The overall incidence of CIN was 6.49% in the treatment group and 7.41% in the control group, with no significant difference between the groups (P=0.68). In subgroup analysis by percutaneous coronary intervention, no significant differences were found between the two groups. In summary, reduced glutathione added to optimal hydration does not further decrease the risk of CIN in elderly patients undergoing coronary angiography or an intervention.
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