Prevention of contrast-induced nephropathy with haemofiltration in high-risk patients after percutaneous coronary intervention.

摘要

BACKGROUND: The incidence of contrast-induced nephropathy (CIN) after percutaneous coronary intervention (PCI) is increasing. The aim of the study is to assess the benefits of prophylactic haemofiltration (PHF) in patients with high risk of developing CIN after PCI. METHODS: 20 patients who underwent PHF after PCI in the context of acute coronary syndrome were selected retrospectively and compared with 20 matched controls with similar risk characteristics. The main variable analysed was the appearance of CIN and the secondary variables were the development of acute clinical kidney failure, heart failure, therapeutic HF and mortality. RESULTS: The baseline characteristics were similar in both groups, with reference creatinine of 2.4 +/- 1.3 mg/dl, contrast used 392 +/- 213 cc and Mehran score of 21.9 +/- 5.2 in the PHF group, as opposed to values of 2.0 +/- 0.6 mg/dl, 368 +/- 126 cc and 20.2 +/- 6.9 respectively in controls. The incidence of CIN was of 6 patients (30%) in the PHF group and 13 patients (65%) in the control group (P=0.03). There were no significant differences in the rest of the variables studied. CONCLUSION: Haemofiltration after PCI may be an effective strategy for the prevention of CIN in patients at high risk of developing it.