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The effect of prophylactic nifedipine on renal function in patients administered contrast media
Z Khoury1, J R Schlicht, J Como
1Department of Internal Medicine, Shadyside Hospital, Pittsburgh, Pennsylvania, USA.
Study Objective:
To determine if prophylaxis with nifedipine could decrease the frequency of contrast medium-induced renal impairment.
Design:
Prospective, randomized clinical trial.
Setting:
A university-affiliated hospital.
Patients:
Patients undergoing scheduled radiologic examinations involving infusion of contrast media.
Interventions:
Forty-two patients were randomized to receive nifedipine 10 mg orally 1 hour before the imaging procedure, and 43 to receive no treatment.
Measurements And Main Results:
Baseline serum creatinine levels were compared with maximum levels 24 and 48 hours after administration of contrast medium. No statistically significant difference was seen in either the mean change or mean percentage change in serum creatinine between the control and nifedipine groups. The mean changes in serum creatinine were +7.4 mumol/L in the control group and +2.7 mumol/L in the nifedipine group (p = 0.33); the mean percentage changes were +10.2% and +4.8%, respectively (p = 0.54).
Conclusion:
Regardless of statistical analysis, it is unlikely that elevations in serum creatinine of this magnitude (< 0.1 mg/dl) are of clinical significance. We therefore conclude that prophylactic nifedipine is not clinically beneficial in preserving renal function in patients receiving contrast medium and that the agent should not be routinely administered for this purpose.