Preview

Eurasian heart journal

Advanced search

Intravenous contrast induced acute kidney injury prevention with high doses of statins

https://doi.org/10.38109/2225-1685-2022-3-84-88

Abstract

   Aim. The aim of our study was to assess the frequency of contrast-induced acute kidney injury (CI-AKI) in patients undergoing computed tomography (CT) with intravenous contrast media and to evaluate the effects of statins in the prevention of CI-AKI.
   Materials and methods. 181 patients undergoing CT with intravenous contrast media administration were included in prospective observational study (ClinicalTrials.gov ID NCT04666389). The primary endpoint was CI-AKI according to KDIGO criteria (the 25 % rise (or 0,5 mg/dl) of serum creatinine from baseline assessed 48–72 hours after administration of contrast media). There were 120 patients in the group with high dose of statins administration and 60 patients without statin treatment. The most frequent cardiovascular disease was hypertension in both groups — 93 % and 85 % respectively.
   Results. CI-AKI was diagnosed in 12 (6,7 %) patients — 9 patients in the no statins group and 3 patients in the statins group. The high dose statin administration statistically significant had less frequency of CI-AKI (p = 0,003) compare with no statins group (OR = 0,144, 95 %CI: 0,037–0,554).
   Conclusion. Statin pretreatment is effective at preventing CI-AKI and should be considered in high-risk patients.

About the Authors

A. A. Vasin
Sechenov First Moscow State Medical University (Sechenov University)
Russian Federation

Andrey A. Vasin, PhD fellow

119435

st. Bol. Pirogovskaya, 6/1

Moscow



O. Iu. Mironova
Sechenov First Moscow State Medical University (Sechenov University)
Russian Federation

Olga Iu. Mironova, Dr. of Sci. (Med.), Prof.

119435

st. Bol. Pirogovskaya, 6/1

Moscow



V. V. Fomin
Sechenov First Moscow State Medical University (Sechenov University); RAS
Russian Federation

Viktor V. Fomin, Dr. of Sci. (Med.), Prof., Corr. Memb.

119435

st. Bol. Pirogovskaya, 6/1

Moscow



References

1. O. V. Demchuk, I. A. Sukmanova, I. V. Ponomarenko, and V. A. Elykomov. Contrast-induced nephropathy in patients with acute coronary syndrome: Clinical significance, diagnosis, prophylaxis. Cardiovasc. Ther. Prev. (Russian Fed.). 2020; 19 (2): 82–88, https://doi.org/10.15829/1728-8800-2019-2255

2. B. J. Barrett et al. Contrast-induced nephropathy in patients with chronic kidney disease undergoing computed tomography: A double-blind comparison of iodixanol and iopamidol,” Invest. Radiol. 2006; 41 (11): 815–821, Nov. https://doi.org/10.1097/01.rli.0000242807.01818.24

3. R. Mehran et al. A simple risk score for prediction of contrast-induced nephropathy after percutaneous coronary intervention: Development and initial validation. J. Am. Coll. Cardiol. 2004; 44 (7): 1393–1399, https://doi.org/10.1016/j.jacc.2004.06.068

4. E. Schönenberger et al. Kidney injury after intravenous versus intra-arterial contrast agent in patients suspected of having coronary artery disease: A randomized trial. Radiology. 2019; 292 (3): 664–672, https://doi.org/10.1148/radiol.2019182220

5. M. Maioli, A. Toso, M. Leoncini, M. Gallopin, N. Musilli, and F. Bellandi, “Persistent renal damage after contrast-induced acute kidney injury: Incidence, evolution, risk factors, and prognosis. Circulation. 2012; 125 (25): 3099–3107, https://doi.org/10.1161/CIRCULATIONAHA.111.085290

6. F. J. Neumann et al. 2018 ESC/EACTS Guidelines on myocardial revascularization. Eur. Heart J. 2019; 40 (2): 87–165, https://doi.org/10.1093/eurheartj/ehy394

7. J. A. Kellum et al. Kidney disease: Improving global outcomes (KDIGO) acute kidney injury work group. KDIGO clinical practice guideline for acute kidney injury. Kidney Int. Suppl. 2012; 2 (1): 1–138, https://doi.org/10.1038/kisup.2012.1

8. M. A. Hossain, E. Costanzo, J. Cosentino, C. Patel, Qaisar H, et al. Contrast-induced nephropathy: Pathophysiology, risk factors, and prevention. Saudi J Kidney Dis Transpl. 2018 Jan-Feb; 29 (1): 1-9. https://doi.org/10.4103/1319-2442.225199, PMID: 29456202

9. C. Quintavalle et al. Impact of a high loading dose of atorvastatin on contrast-induced acute kidney injury. Circulation, 126 (25): 3008–3016, 2012, https://doi.org/10.1161/CIRCULATIONAHA.112.103317

10. M. Leoncini, A. Toso, M. Maioli, F. Tropeano, and F. Bellandi, “Statin treatment before percutaneous cononary intervention. J. Thorac. Dis. 2013; 5 (3): 335–342, https://doi.org/10.3978/j.issn.2072-1439.2013.05.09

11. X. Zhou et al. Comparative Efficacy of Statins for Prevention of Contrast-Induced Acute Kidney Injury in Patients With Chronic Kidney Disease: A Network Meta-Analysis. Angiology. 2019; 70 (4): 305–316, https://doi.org/10.1177/0003319718801246


Review

For citations:


Vasin A.A., Mironova O.I., Fomin V.V. Intravenous contrast induced acute kidney injury prevention with high doses of statins. Eurasian heart journal. 2022;(3):84-88. (In Russ.) https://doi.org/10.38109/2225-1685-2022-3-84-88

Views: 1243


ISSN 2225-1685 (Print)
ISSN 2305-0748 (Online)