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Alprostadil protects type 2 diabetes mellitus patients treated with metformin from contrast-induced nephropathy

  • Nephrology - Original Paper
  • Published:
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Abstract

Purpose

Type 2 diabetes mellitus (T2DM) patients treated with metformin are predisposed to develop contrast-induced nephropathy (CIN) after received emergency contrast-enhanced computed tomography (CT) examination. We evaluated the protective effects of alprostadil on CIN in T2DM patients treated with metformin after contrast media (CM) administration.

Methods

In this single-institution, single-blind, superiority trial, we randomly assigned 451 T2DM patients taking metformin and underwent emergency contrast-enhanced CT examination to either the alprostadil group (227 patients) receiving alprostadil or the control group (224 patients) without alprostadil. All subjects stopped taking metformin and drank 500 ml water within 12 h after CM exposure. In addition, patients in the alprostadil group were injected with alprostadil (10 μg/day, for 3 days) plus 20 ml normal saline (alprostadil hydration) and the control group patients were daily injected with 20 ml normal saline as control for 3 days following CM administration. Serum creatinine (Scr) was measured before and <72 h after contrast-enhanced CT examination. CIN was defined as an increase in Scr ≥ 44.2 µmol/l (0.5 mg/dL) or >25% over baseline within 3 days of contrast administration.

Results

There was a lower incidence of CIN in patients underwent alprostadil hydration than drinking water monohydration after CM administration, who with either normal renal function or chronic kidney disease (baseline eGFR < 60 ml·min−1·1.73 m−2).

Conclusions

Alprostadil hydration was superior to drinking water monohydration regarding preventing CIN in T2DM patients treated with metformin after contrast-enhanced CT.

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Acknowledgements

We acknowledge Dr. Xiaofang Wei for helpful discussions. We also thank Danni Zhu for her assistance in experimental procedures. This work is partially supported by the key project of Qingdao Health Bureaugrant10-4-2-5-jch. The funder had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

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Author notes

  1. Jing Wang and Xiaobo Ai Contributed equally to this work.

Authors and Affiliations

  1. The Department of Endocrinology and Metabolism, The Affiliated Hospital of Qingdao University, Qingdao, 266100, China

    Jing Wang, Li Li & Yanyan Gao

  2. Department of Nephrology, Qingdao Fifth People’s Hospital, Qingdao, 266000, China

    Xiaobo Ai

  3. Department of Respiratory Medicine, The Affiliated Hospital of Qingdao University, Qingdao, 266100, China

    Nina Sun

  4. Gout Laboratory, The Affiliated Hospital of Qingdao University, Shandong Provincial Key Laboratory of Metabolic Diseases, QingdaoUniversity, Qingdao, 266100, China

    Changgui Li

  5. Biotherapy Center, The Affiliated Central Hospital of Qingdao University, Qingdao, 266042, China

    Weihong Sun

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  1. Jing Wang
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  2. Xiaobo Ai
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  3. Li Li
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  5. Nina Sun
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Correspondence to Changgui Li or Weihong Sun.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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The authors declare that they have no conflict of interest.

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Informed consent was obtained from all individual participants included in the study.

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Wang, J., Ai, X., Li, L. et al. Alprostadil protects type 2 diabetes mellitus patients treated with metformin from contrast-induced nephropathy. Int Urol Nephrol 49, 2019–2026 (2017). https://doi.org/10.1007/s11255-017-1639-2

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  • DOI: https://doi.org/10.1007/s11255-017-1639-2

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