Prevention of contrast-induced nephropathy with prostaglandin E1 in high-risk patients undergoing percutaneous coronary intervention

Purpose

Contrast-induced nephropathy (CIN) is an important complication in the use of iodinated contrast media. The present study aimed to assess the safety and efficacy of prostaglandin E₁ (PGE₁) in prevention of CIN in patients with high-risk factors undergoing percutaneous coronary intervention (PCI).

Methods

The study group consisted of 163 patients who had undergone a coronary intervention procedure between January 1, 2012 and October 31, 2012. Study participants were randomly assigned to either the PGE₁ group (82 patients) or the control group (81 patients). Patients in the PGE₁ group received PGE₁ intravenous infusion of 20 ng/kg/min for 6 h before and after the administration of contrast media. The control group received 0.9 % sodium chloride solution for routine hydration only. A nonionic, low-osmolality contrast agent was used in our laboratory at this time. Serum creatinine (Scr) values and estimated glomerular filtration rate were measured before and within 48 h of the administration of contrast agents. CIN was defined as an increase of ≥0.5 mg/dL or ≥ a 25 % increase in Scr concentrations over baseline within 48 h of angiography.

Results

The amount of contrast agent administered was similar for the PGE₁ and control groups (156 ± 63 vs. 161 ± 68 mL, P > 0.05). The incidence of CIN was lower in the PGE₁ group than in the control group (3.7 vs. 11.1 %, P < 0.05). No serious adverse effects were observed.

Conclusions

In patients with high-risk factors undergoing PCI, the use of PGE₁ for prevention of CIN is safe and efficacious.