Comparison of isotonic and hypotonic contrast agent in inducing contrast induced nephropathy after percutaneous coronary intervention

HU Yun-zhao; TAN Ning; LI Guang; LU Jian-hua; WU Yan-xian

摘要：The incidence of contrast induced nephropathy(CIN)is increasing while patients are more and more frequently undertaking coronary angiography and percutaneous coronary intervention(PCI).CIN correlates with the later cardiovascular events,the rising mortality risks and the increasing one-year target vessel revascularization.At present,few articles reported on whether the incidence of CIN induced by isotonic and hypotonic contrast agent after PCI is different or not.Objectives To investigate the different effect of isotonic and hypotonic contrast agent in inducing CIN in patients with coronary artery disease after PCI.Methods We enrolled 355 patients with coronary artery disease who undertook PCI from January 2007 to December 2008 as subjects.Renal functions of all 355 patients were normal.Patients were randomly divided into isotonic group and hypotonic group.Concentrations of serum creatinine(SCr)were measured before,48～72 hours and 7 days(if needed)after PCI.The glomerular filtration rate(eGFR)was calculated according to MDRD formula.The incidence of CIN was defined as the concentration of SCr≥0.5 mg/dL(44.2μmol/L).Hemodialysis rates and mortality were recorded in the hospital.Results There was no significant difference in the basline eGFR(79.52±5.28 vs 81.03±6.09,P＞0.05),dosages of contrast agent(125.68±15.88 mL vs123.51±16.38 mL,P＞0.05),eGFR of 48-72 hours after PCI(70.26±9.48 vs 69.06±9.59,P＞0.05)and incidences of CIN(5.56% vs 5.78%,P＞0.05)between the two groups,eGFR and concentrations of SCr 7 days after PCI showed no significant difference between the two groups(P＞0.05).No patient was dead or needed hemodialysis in hospital.Conclusions The effect of isotonic and hypotonic contrast agent in inducing CIN in patients with coronary artery disease after PCI has no difference.