Erschienen in:
01.08.2013 | Nephrology - Original Paper
Alprostadil plays a protective role in contrast-induced nephropathy in the elderly
verfasst von:
Ya Miao, Yuan Zhong, Hong Yan, Wei Li, Bei-Yun Wang, Jun Jin
Erschienen in:
International Urology and Nephrology
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Ausgabe 4/2013
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Abstract
Purpose
To evaluate the protective effects of alprostadil on contrast-induced nephropathy (CIN) in elderly patients.
Methods
We randomized 370 patients into the control or alprostadil group. The patients in the control group were injected with 100 ml sterile saline and the patients in the alprostadil group with alprostadil (0.4 μg/kg/day) in 100 ml sterile saline before and after iohexol-enhanced (100 ml) computed tomography (CT). Serum creatinine (Scr), blood urea nitrogen (BUN), cystatin C (CysC), and creatinine clearance (Ccr) were analyzed or calculated. ΔScr and ΔCysC were determined by the changes between baseline and highest Scr and CysC levels. The standard for CIN was a postdose Scr increase >44.2 μmol/l or >25 % over baseline.
Results
In the control group, peak Scr (P < 0.05) and ΔScr (P < 0.01) were higher than those in the alprostadil group. The postdose CysC at 24 h (P < 0.05), 48 h (P < 0.05), and 72 h (P < 0.05), peak CysC (P < 0.01), and ΔCysC (P < 0.05) in the control group were higher than those in the alprostadil group. The incidence of CIN in the control group was 22.2 %, which was higher than in the alprostadil group (9.1 %, P < 0.01). Subgroup analyses in patients with advanced age (≥80 years), concomitant hypertension or diabetes, and abnormal baseline renal function (Ccr ≤60 ml/min) showed that the alprostadil group had lower ΔScr and ΔCysC than the control group after contrast-enhanced CT examination in all four subgroups (P < 0.05 or P < 0.01).
Conclusions
In this cohort of older patients undergoing contrast CT, the use of alprostadil reduced the incidence of CIN.