Related Experiment Video
Updated: Aug 9, 2026
Ischemia-reperfusion Model of Acute Kidney Injury and Post Injury Fibrosis in Mice
Published on: August 9, 2013
Lack of Serum Creatinine Decrease After Coronary Angiography Despite Prophylactic Hydration After Routine Coronary
Pawel Burchardt1, Janusz Rzezniczak, Tomasz Synowiec
1Department of Biology and Environmental Sciences, Poznan University of Medical Sciences, Poznan, Poland.
Insights
In some patients, prophylactic hydration does not lower serum creatinine after contrast procedures. Abnormal glucose metabolism and better baseline kidney function predict this lack of creatinine reduction, warranting further study.
Area of Science:
- Nephrology
- Cardiology
- Radiology
Background:
- Prophylactic hydration is standard to prevent contrast-induced renal dysfunction.
- A significant percentage of patients do not show a drop in serum creatinine (SCR) 12-18 hours post-procedure.
- Clinical predictors for this phenomenon are not well understood.
Purpose of the Study:
- To investigate the clinical reasons for the lack of SCR reduction after contrast administration.
- To identify predictors of this outcome in patients undergoing coronary angiography/angioplasty.
Main Methods:
- Retrospective analysis of 341 patients undergoing elective coronary angiography/angioplasty with prophylactic hydration.
- Serum creatinine measured pre- and post-procedure (12-18 hours).
- Analysis of red blood cell count, hemoglobin, and hematocrit to assess hydration status; evaluation of glucose metabolism and renal function parameters.
Main Results:
- Dehydration explained the lack of SCR reduction in only a minority of cases (13.5%-20%).
- Predictors included abnormal glucose metabolism combined with specific baseline renal function parameters (e.g., SCR <0.87 mg/dL, GFR >80.08 mL/min/1.73 m2).
- Lack of SCR reduction was more common in patients with initially better renal function.
Conclusions:
- The study identified specific clinical predictors for the absence of serum creatinine reduction post-contrast.
- Further prospective research on a larger patient cohort is recommended.
Background/Aims:
To prevent contrast induced renal dysfunction a periprocedural prophylactic hydration is applied. Due to dilution it should cause a drop in serum creatinine concentration (SCR). Surprisingly, no reduction in SCR after contrast admission is found in up to 25% of patients as early as 12-18 hours after coronary angiography/angioplasty. This study aims to find a clinical explanation as well as predict circumstances for this phenomenon.
Methods:
Retrospective clinical and laboratory data was used from 341 patients who underwent elective coronary angiography/angioplasty, received a prophylactic hydration, and had serum creatinine concentration measured prior to, and 12-18 hours after invasive procedure with iodine contrast administration. To exclude an improper hydration due to no creatinine decrease, the number of red blood cells was analysed as well as hemoglobin and hematocrit in blood donations collected during the study time points.
Results:
The resulting lack of serum creatinine reduction could be explained by dehydration (measured by increase in number of RBC, HGB and HCT) only in 13.5% , 10.8%, and 20% of cases, respectively. Any form of abnormal glucose metabolism combined with either baseline serum creatinine concentration <0.87 mg/dL or creatinine clearance >86.77 mL/min, or GFR by CKD EPI >80.08 mL/min/1.73 m2, or GFR by MDRD >74.48 mL/min/1.73 m2 were the predictors for no creatinine decrease at outcome. Additionally, it was demonstrated that the lack of creatinine decrease was more often observed among those patients whose initial renal function was better than in the subjects with reduction of SCR.
Conclusions:
This observation requires further prospective investigation on extended group of patients.
More Related Videos
Related Concept Videos
01:25Drug Dosing in Renal Diseases: Measurement of Serum Creatinine Concentration and Clearance
01:28Cardiac Catheterization I: Pre-Procedure Overview
01:27Coronary Artery Disease V: Interprofessional Care
01:30Acute Coronary Syndrome III: Diagnostic Studies
01:26Angina IV: Management
01:30Acute Kidney Injury IV: Diagnostic Studies and Prevention