Skip to main content
SpringerLink
Log in

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

  • Nephrology - Original Paper
  • Published:
International Urology and Nephrology Aims and scope Submit manuscript

Abstract

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. McCullough PA, Sandberg KR (2003) Epidemiology of contrast-induced nephropathy. Rev Cardiovasc Med 4:S3–S9

    Google Scholar 

  2. Parfrey P (2005) The clinical epidemiology of contrast-induced nephropathy. Cardiovasc Interv Radiol 28(Suppl 2):S3–S11

    Article  Google Scholar 

  3. Mehran R, Nikolsky E (2006) Contrast-induced nephropathy: definition, epidemiology, and patients at risk. Kidney Int Suppl 69(100):S11–S15

    Article  CAS  Google Scholar 

  4. Hogan S, Gurm HS (2011) Preventing contrast-induced nephropathy in patients undergoing primary PCI. J Invasive Cardiol 23(11):451–452

    PubMed  Google Scholar 

  5. Zhou Y, Yuan WJ, Zhu N, Wang L (2011) Short-term, high-dose statins in the prevention of contrast-induced nephropathy: a systematic review and meta-analysis. Clin Nephrol 76(6):475–483

    Article  PubMed  CAS  Google Scholar 

  6. Mehran R, Aymong ED, Nikolsy E, Lasic Z, Iakovou I, Fahy M (2004) A simple risk score for prediction of contrast-induced nephropathy after percutaneous coronary intervention: development and initial validation. J Am Coll Cardiol 44(7):1393–1399

    PubMed  Google Scholar 

  7. Sketch MH Jr, Whelton A, Schollmayer E, Koch JA, Bernink PJ, Woltering F (2001) Prevention of contrast media-induced renal dysfunction with prostaglandin E1: a randomized, double-blind, placebo-controlled study. Am J Ther 8(3):155–162

    Article  PubMed  Google Scholar 

  8. Ma YC, Zuo L, Chen JH, Luo Q, Yu XQ, Li Y, Xu JS, Huang SM, Wang LN, Huang W, Wang M, Xu GB, Wang HY (2006) Modified glomerular filtration rate estimating equation for Chinese patients with chronic kidney disease. J Am Soc Nephrol 17(10):2937–2944

    Article  PubMed  Google Scholar 

  9. Li WH, Li DY, Han F, Xu TD, Zhang YB, Zhu H (2013) Impact of anemia on contrast-induced nephropathy (CIN) in patients undergoing percutaneous coronary interventions. Int Urol Nephrol 45(8):1065–1070

    Article  PubMed Central  PubMed  Google Scholar 

  10. Liu YH, Liu Y, Tan N, Chen JY, Chen J, Chen SH, He YT, Ran P, Ye P, Li Y(2013) Predictive value of GRACE risk scores for contrast-induced acute kidney injury in patients with ST-segment elevation myocardial infarction before undergoing primary percutaneous coronary intervention. Int Urol Nephrol. Nov 22. [Epub ahead of print]

  11. Rach D, Drescher P, Pereia FJ, Knes JN, Will JA, Madsen PO (1997) Comparison of iodinated contrast media-induced renal vasoconstriction in human, rabbit, dog, and pig arteries. Invest Radiol 32(6):315–319

    Article  Google Scholar 

  12. Mehran R (2007) Contrast-induced nephropathy remains a serious complication of PCI. J Interv Cardiol 20(3):236–240

    Article  PubMed  Google Scholar 

  13. Sandhu C, Newman DJ, Morgan R, Beli AM, Oliveria D (2002) The role of oxygen free radicals in contrast induced nephrotoxicity. Acad Radiol 9:S436–S437

    Article  PubMed  Google Scholar 

  14. Bartorelli AL, Marenzi G (2008) Contrast-induced nephropathy. J Interv Cardiol 21(1):74–85

    Article  PubMed  Google Scholar 

  15. Idee JM, Lancelot E, Berthommier C, Couturier-Goulas V, Vazin V, Corotc C (2000) Effect of non-ionic monomeric and dimeric iodinated contrast media on renal and systemic haemodynamics in rats. Fundam Clin J Pharmacol 14(1):11–18

    Article  CAS  Google Scholar 

  16. Persson PB, Hansell P, Liss P (2005) Pathophysiology of contrast medium-induced nephropathy. Kidney Int 68(1):14–22

    Article  PubMed  CAS  Google Scholar 

  17. Thomsen HS (2005) How to avoid CIN: guidelines from the European Society of Urogenital Radiology. Nephrol Dial Transpl 20:i18–i22

    Article  Google Scholar 

  18. Trivedi HS, Moore H, Nasr S, Aggarwal K, Agrawal A, Goel P (2003) A randomized prospective trial to assess the role of saline hydration on the development of contrast nephrotoxicity. Nephron Clin Pract 93:C29–C34

    Article  PubMed  CAS  Google Scholar 

  19. Rosenstock JL, Gilles E, Geller AB, Panagopoulos G, Mathew S, Malieckal D, DeVita MV, Michelis MF (2010) Impact of heart failure on the incidence of contrast-induced nephropathy in patients with chronic kidney disease. Int Urol Nephrol 42(4):1049–1054

    Article  PubMed  CAS  Google Scholar 

  20. Wu CC, Wu CI, Wang WY, Wu YC (2007) Low concentrations of resveratrol potentiate the antiplatelet effect of prostaglandins. Planta Med 73(5):439–443

    Article  PubMed  CAS  Google Scholar 

  21. Dolegowska B, Pikula E, Safranow K, Olszewska M, Jakubowska K, Chlubek D (2006) Metabolism of eicosanoids and their action on renal function during ischemia and reperfusion: the effect of alprostadil. Prostaglandins Leukot Essent Fat Acids 75(6):403–411

    Article  CAS  Google Scholar 

  22. Ling W, Zhaohui N, Ben H, Leyi G, Jianping L, Huili D (2008) Urinary IL-18 and NGAL as early predictive biomarkers in contrast-induced nephropathy after coronary angiography. Nephron Clin Pract 108(3):c176–c181

    Article  PubMed  CAS  Google Scholar 

  23. Bachorzewska-Gajewska H, Malyszko J, Sitniewska E, Malyszko JS, Pawlak K, Mysliwiec M, Lawnicki S, Szmitkowski M, Dobrzycki S (2007) Could neutrophil-gelatinase-associated lipocalin and cystatin C predict the development of contrast-induced nephropathy after percutaneous coronary interventions in patients with stable angina and normal serum creatinine values ? Kidney Blood Press Res 30(6):408–415

    Article  PubMed  CAS  Google Scholar 

  24. McCullough PA (2008) Contrast-induced acute kidney injury. J Am Coll Cardiol 51(15):1419–1428

    Article  PubMed  Google Scholar 

  25. Miao Y, Zhang Y, Yan H, Li W, Yun B, Jin J (2013) Alprostadil plays a protective role in contrast-induced nephropathy in the elderly. Int Urol Nephrol 45(4):1179–1185

    Article  PubMed  Google Scholar 

  26. Firouzi A, Eshraghi A, Shakerian F, Sanati HR, Salehi N, Zahedmehr A, Kiani R, Madani M, Pedarzadeh A (2012) Efficacy of pentoxifylline in prevention of contrast-induced nephropathy in angioplasty patients. Int Urol Nephrol 44(4):1145–1149

    Article  PubMed  CAS  Google Scholar 

  27. Yavari V, Ostovan MA, Kojuri J, Afshariani R, Hamidian A, Roozbeh J, Pakfetrat M (2014) The preventive effect of pentoxifylline on contrast-induced nephropathy: a randomized clinical trial. Int Urol Nephrol 46(1):41–46

    Article  PubMed  CAS  Google Scholar 

  28. Wu MY, Hsiang HF, Wong CS, Yao MS, Li YW, Hsiang CY, Bai CH, Hsu YH, Lin YF, Tam KW (2013) The effectiveness of N-Acetylcysteine in preventing contrast-induced nephropathy in patients undergoing contrast-enhanced computed tomography: a meta-analysis of randomized controlled trials. Int Urol Nephrol 45(5):1309–1318

    Article  PubMed  CAS  Google Scholar 

  29. Koch JA, Plum J, Grabensee B, Mödder U (2000) PGE1 Study Group: prostaglandin E1: a new agent for the prevention of renal dysfunction in high risk patients caused by radiocontrast media? Nephrol Dial Transpl 15(1):43–49

    Article  CAS  Google Scholar 

Download references

Acknowledgments

This study was supported by the Xuzhou Medical College Science Foundation.

Conflict of interest

None.

Author information

Authors and Affiliations

  1. Department of Cardiology, Affiliated Hospital of XuZhou Medical College, No. 99 Huaihai West Road, Xuzhou, 221002, China

    Wen-Hua Li, Dong-Ye Li, Wen-Hao Qian, Jia-Li Liu, Tong-Da Xu, Hong Zhu & Hai-Yan He

Authors
  1. Wen-Hua Li
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Dong-Ye Li
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Wen-Hao Qian
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Jia-Li Liu
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Tong-Da Xu
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Hong Zhu
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Hai-Yan He
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Wen-Hua Li.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Li, WH., Li, DY., Qian, WH. et al. Prevention of contrast-induced nephropathy with prostaglandin E1 in high-risk patients undergoing percutaneous coronary intervention. Int Urol Nephrol 46, 781–786 (2014). https://doi.org/10.1007/s11255-014-0674-5

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11255-014-0674-5

Keywords

Search

Navigation