The prophylactic effect of alprostadil on contrast-induced nephropathy in renal insufficiency patients after percutaneous coronary intervention

This study explored and analyzed the prophylactic effect of Alprostadil on contrast-induced nephropathy (CIN) after percutaneous coronary intervention (PCI) in patients with renal insufficiency.

From June 2014 to June 2017, 156 patients with coronary artery disease and renal insufficiency who electively underwent PCI in our hospital were enrolled and randomly divided into Alprostadil group (n=77) and placebo control group (n=79) by random number table. The control group was given hydration and placebo, while the observation group received hydration and Alprostadil. The alprostadil and placebo were infused intravenously 30-90 minutes before operation until four hours after surgery. The changes of biochemical indicators, serum creatinine (Scr), glomerular filtration rate (GFR), the level of neutrophil gelatinase-associated lipocalin (NGAL) in urinary neutrophils, and the incidence of CIN were compared between the two groups of patients before and after PCI surgery.

The difference of SCr and GFR between the two groups of patients was statistical insignificant before and after PCI surgery (P>0.05), while the level of NGAL in both groups 12 h and 24 h after operation were critically higher than those prior-operation (P<0.05), and the increase in the control group was more obvious (P<0.05). The serum CysC, Hcy, and hs-CRP levels of the two groups 24 h after surgery were remarkably higher than those before surgery (P<0.05), and the indicators in observation group were superior to those in control group after surgery (P<0.05). The difference between the two groups of patients in incidence of CIN primary endpoint was statistically insignificant (P>0.05), while the incidence of secondary endpoint of CIN ≥ 0.3 mg/dL in Alprostadil group was significantly lower than that in control group (P<0.05).

For renal insufficiency patients undergoing PCI, the associative usage of Alpromazil with routine treatment can effectively prevent CIN and is worthy of clinical promotion.