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.
Similar content being viewed by others
References
McCullough PA, Sandberg KR (2003) Epidemiology of contrast-induced nephropathy. Rev Cardiovasc Med 4:S3–S9
Parfrey P (2005) The clinical epidemiology of contrast-induced nephropathy. Cardiovasc Interv Radiol 28(Suppl 2):S3–S11
Mehran R, Nikolsky E (2006) Contrast-induced nephropathy: definition, epidemiology, and patients at risk. Kidney Int Suppl 69(100):S11–S15
Hogan S, Gurm HS (2011) Preventing contrast-induced nephropathy in patients undergoing primary PCI. J Invasive Cardiol 23(11):451–452
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
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
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
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
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
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]
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
Mehran R (2007) Contrast-induced nephropathy remains a serious complication of PCI. J Interv Cardiol 20(3):236–240
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
Bartorelli AL, Marenzi G (2008) Contrast-induced nephropathy. J Interv Cardiol 21(1):74–85
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
Persson PB, Hansell P, Liss P (2005) Pathophysiology of contrast medium-induced nephropathy. Kidney Int 68(1):14–22
Thomsen HS (2005) How to avoid CIN: guidelines from the European Society of Urogenital Radiology. Nephrol Dial Transpl 20:i18–i22
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
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
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
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
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
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
McCullough PA (2008) Contrast-induced acute kidney injury. J Am Coll Cardiol 51(15):1419–1428
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
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
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
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
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
Acknowledgments
This study was supported by the Xuzhou Medical College Science Foundation.
Conflict of interest
None.
Author information
Authors and Affiliations
Corresponding author
Rights 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
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11255-014-0674-5