Prophylactic hemodialysis after radiocontrast media in patients with renal insufficiency is potentially harmful

Détails

ID Serval
serval:BIB_459F7A4CE516
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Prophylactic hemodialysis after radiocontrast media in patients with renal insufficiency is potentially harmful
Périodique
American Journal of Medicine
Auteur(s)
Vogt  B., Ferrari  P., Schonholzer  C., Marti  H. P., Mohaupt  M., Wiederkehr  M., Cereghetti  C., Serra  A., Huynh-Do  U., Uehlinger  D., Frey  F. J.
ISSN
0002-9343 (Print)
Statut éditorial
Publié
Date de publication
12/2001
Volume
111
Numéro
9
Pages
692-8
Notes
Clinical Trial
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't --- Old month value: Dec 15
Résumé
PURPOSE: Acute renal failure induced by contrast media is an important cause of hospital-acquired renal insufficiency. Preexisting renal failure and the dose of contrast media are known risk factors for the development of radiocontrast nephropathy. We performed a randomized trial to test whether radiocontrast nephropathy can be avoided by prophylactic hemodialysis immediately after the administration of contrast media in patients with impaired renal function. SUBJECTS AND METHODS: Renal function and other parameters, hemodialysis requirement, and relevant clinical events were recorded before and during the 6 days after administration of contrast media in 113 patients with a baseline serum creatinine level >200 microm/L (>2.3 mg/dL). Patients were randomly assigned to either hemodialysis (n = 55) or nonhemodialysis (n = 58) treatment after parenteral low-osmolality contrast media. RESULTS: The characteristics of the patients in the two groups were similar. Compared with baseline levels, the mean [+/- SD] serum creatinine level decreased at day 1 (277 +/- 95 microm/L), peaked at day 4 (353 +/- 126 microm/L), and returned to baseline at day 6 (327 +/- 119 microm/L, P <0.05 by analysis of variance) after administration of contrast media in the hemodialysis group, whereas in the nonhemodialysis group, no significant changes in mean serum creatinine level were observed. Eleven patients required 1 or more hemodialyses (8 in the hemodialysis group and 3 in the nonhemodialysis group, P = 0.12), 6 of whom (4 vs. 2, P = 0.44) required 3 or more hemodialyses. Clinically relevant events included pulmonary edema (1 vs. 4 patients, P = 0.36), myocardial infarction (2 vs. 2), stroke (2 vs. 0, P = 0.24), and death (1 vs. 1). CONCLUSIONS: The strategy of performing hemodialysis immediately after the administration of low-osmolality contrast media in all patients with a reduced renal function did not diminish the rate of complications, including radiocontrast nephropathy.
Mots-clé
Aged Contrast Media/*adverse effects Creatinine/blood Female Humans Kidney Failure, Acute/*chemically induced/*prevention & control *Kidney Failure, Chronic Logistic Models Male *Renal Dialysis/adverse effects
Pubmed
Web of science
Création de la notice
25/01/2008 14:03
Dernière modification de la notice
03/03/2018 16:46
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