Prevention of contrast-induced nephropathy with single bolus erythropoietin in patients with diabetic kidney disease: A randomized controlled trial

Lilach Shema-Didi, Batya Kristal, Sarit Eizenberg, Nabil Marzuq, Majdy Sussan, Yulie Feldman-Idov, Pnina Ofir, Shaul Atar

Research output: Contribution to journalArticlepeer-review

10 Scopus citations

Abstract

Aim Contrast-induced-nephropathy (CIN) is associated with poor outcomes, thus prevention of CIN may be of clinical value. Erythropoietin (EPO) has been shown to elicit tissue-protective effects in experimental models and in clinical studies of acute kidney injury. We therefore evaluated its effectiveness for prevention of CIN after coronary angiography (CA) ± percutaneous coronary intervention (PCI) in diabetic patients with chronic kidney disease. Methods A prospective, randomized, controlled trial was carried out in 138 diabetic patients with EGFR <60mL/min who underwent non-urgent CA ± PCI. Patients received normal saline and n-acetyl cysteine before CA, with or without 50 000 U of EPO administered 30 min prior to CA. CIN was defined as an increase in serum creatinine of at least 0.5 mg/dL during the first 2 days after exposure to contrast media. Primary outcome was the incidence of CIN. Secondary outcomes were the sensitivity and positive predictive value (PPV) of Cystatin C (CC) and Neutrophil-gelatinase-associated-lipocalin (NGAL) for diagnosis of CIN. Results The observed incidence of CIN was 8.7%, significantly lower than the expected for such high-risk population. The administration of EPO prior to CA did not reduce the incidence of CIN (9.7% vs. 7.6%, P = 0.65). CC and NGAL demonstrated a low sensitivity (16.6%) and low PPV (6.7 and 33.3%, respectively) for detecting CIN. Conclusion The administration of EPO prior to CA did not reduce the incidence of CIN. Additional prospective research with a larger sample size and in other patient categories is essential to further define the potential protective effect of EPO on prevention of CIN.

Original languageEnglish
Pages (from-to)295-300
Number of pages6
JournalNephrology
Volume21
Issue number4
DOIs
StatePublished - 1 Apr 2016

Bibliographical note

Publisher Copyright:
© 2015 Asian Pacific Society of Nephrology.

Keywords

  • acute kidney injury
  • angiography
  • chronic kidney disease
  • contrast media
  • erythropoietin

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