1. Simplified Rapid Hydration Prevents Contrast-Associated Acute Kidney Injury Among CKD Patients Undergoing Coronary Angiography.
- Author
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Liu Y, Tan N, Huo Y, Chen SQ, Liu J, Wang Y, Li L, Tao JH, Su X, Zhang L, Li QX, Zhang JY, Guo YS, Du ZM, Zhou YP, Fang ZF, Xu GM, Liang Y, Tao L, Chen H, Ji Z, Han B, Chen PY, Ge JB, Han YL, and Chen JY
- Subjects
- Humans, Coronary Angiography adverse effects, Saline Solution, Treatment Outcome, Acute Kidney Injury chemically induced, Acute Kidney Injury diagnosis, Acute Kidney Injury prevention & control, Renal Insufficiency, Chronic complications, Renal Insufficiency, Chronic diagnosis
- Abstract
Background: Patients with chronic kidney disease (CKD) undergoing coronary angiography (CAG) are at high risk of contrast-associated acute kidney injury (CA-AKI) and mortality. Therefore, there is a clinical need to explore safe, convenient, and effective strategies for preventing CA-AKI., Objectives: This study sought to assess whether simplified rapid hydration is noninferior to standard hydration for CA-AKI prevention in patients with CKD., Methods: This multicenter, open-label, randomized controlled study was conducted across 21 teaching hospitals and included 1,002 patients with CKD. Patients were randomized to either simplified hydration (SH) (SH group, with normal saline from 1 hour before to 4 hours after CAG at a rate of 3 mL/kg/h) or standard hydration (control group, with normal saline 12 hours before and 12 hours after CAG at a rate of 1 mL/kg/h). The primary endpoint of CA-AKI was a ≥25% or 0.5-mg/dL rise in serum creatinine from baseline within 48 to 72 hours., Results: CA-AKI occurred in 29 of 466 (6.2%) patients in the SH group and in 38 of 455 (8.4%) patients in the control group (relative risk: 0.8; 95% CI: 0.5-1.2; P = 0.216). In addition, the risk of acute heart failure and 1-year major adverse cardiovascular events did not differ significantly between the groups. However, the median hydration duration was significantly shorter in the SH group than in the control group (6 vs 25 hours; P < 0.001)., Conclusions: In CKD patients undergoing CAG, SH is noninferior to standard hydration in preventing CA-AKI with a shorter hydration duration., Competing Interests: Funding Support and Author Disclosures This study was funded by the Beijing Lisheng Cardiovascular Health Foundation (LHJJ20141751), Guangdong Provincial Science and Technology Project (2020B1111170011 and KJ022021049), and Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention (No. Y0120220151), Multi-center study on key techniques for prevention, diagnosis, and treatment of high-risk coronary artery disease (DFJH2020026). The funders were not involved in study design, data collection, analysis, interpretation, or reporting. All authors have reported that they have no relationships relevant to the contents of this paper to disclose., (Copyright © 2023 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.)
- Published
- 2023
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