Contrast-induced acute kidney injury in high risk patients undergoing invasive cardiac procedures

Contrast-induced acute kidney injury in high risk patients undergoing invasive cardiac procedures Introduction: Acute renal function impairment associated with radiologic procedures, known as contrast-induced acute kidney injury (CI-AKI), is strongly associated with a higher rate of morbidity, in-hospital mortality and diminished long-term survival. CI-AKI prevention focuses mainly on adequate periprocedural hydratation and use of a low amount of contrast media. Previous trials concerning use of adenosine antagonist theophylline revealed contradictory results. Goals: Our interventional trial sought to evaluate the effect of theophylline in CI-AKI prevention in well hydrated elderly patients with chronic kidney disease. Our cross-sectional study focused on CI-AKI in patients undergoing primary PCI for ST segment elevation myocardial infarction (STEMI). Methods: Interventional trial: randomized, double-blind, placebo-controlled trial was performed. 56 patients with estimated glomerular filtration rate bellow 60 60 ml/min/1.73m2 referred for cardiac coronary angiography and/or angioplasty were enrolled. 31 of them were randomly assigned to 200 mg theophylline IV before procedure, and 25 to placebo. Iso- osmolar contrast Iodixanol was used. Trial protocol included mandatory parenteral hydration. The..