Contrast Induced Nephropathy: Efficacy of Matched Hydration and Forced Diuresis for prevention inpatients with impaired renal function undergoing coronary procedures - CINEMA Trial

Aram J. Mirza; Kashan Ali; Farhad Huwez; Abdulsalam Y. Taha; Farman J. Ahmed; Shahow A. Ezzaddin; Zana I. Abdulrahman; Chim C. Lang

doi:10.1016/j.ijcha.2022.100959

Contrast Induced Nephropathy: Efficacy of Matched Hydration and Forced Diuresis for prevention inpatients with impaired renal function undergoing coronary procedures - CINEMA Trial

Aram J. Mirza, Kashan Ali, Farhad Huwez, Abdulsalam Y. Taha, Farman J. Ahmed, Shahow A. Ezzaddin, Zana I. Abdulrahman, Chim C. Lang (Lead / Corresponding author)

Postgraduate Medicine

Research output: Contribution to journal › Article › peer-review

11 Citations (Scopus)

116 Downloads (Pure)

Abstract

Background: Matched hydration and forced diuresis (MHFD) using the RenalGuard device has been shown to reduce contrast induced nephropathy (CIN) following coronary interventions.

Aim: To evaluate the potential benefits of a non-automated MHFD protocol compared to current hydration protocol in prevention of CIN in patients with CKD.

Methods: A total of 1,205 patients were randomized to either non-automated MHFD group (n = 799) or intravenous hydration control group (n = 406). The MHFD group received 250 ml IV normal saline over 30 min before the coronary procedure followed by 0.5 mg/kg IV furosemide. Hydration infusion rate was manually adjusted to replace the patient's urine output. When urine output rate reached > 300 ml/h, patients underwent coronary procedure. Matched fluid replacement was maintained during the procedure and for 4-hour post-treatment. CIN was defined conventionally as ≥ 25% or ≥ 0.5 mg/dl rise in serum creatinine over baseline.

Results: CIN occurred in 121 of 1,205 (10.0%) patients in our study. With respect to the primary outcome, 64 (8.01%) of the MHFD patients developed CIN compared with 57 (14.04%) of the control group (p < 0.001).

Conclusions: A non-automated MHFD protocol is an effective and safe method for the prevention of CIN in patients with CKD.

Original language	English
Article number	100959
Pages (from-to)	1-5
Number of pages	5
Journal	IJC Heart & Vasculature
Volume	39
Early online date	1 Feb 2022
DOIs	https://doi.org/10.1016/j.ijcha.2022.100959
Publication status	Published - Apr 2022

Keywords

Contrast-induced nephropathy
renal impairment
contrast media
coronary angiography
percutaneous coronary intervention
matched hydration and forced diuresis

ASJC Scopus subject areas

Cardiology and Cardiovascular Medicine

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10.1016/j.ijcha.2022.100959Licence: CC BY

Final Published VersionFinal published version, 855 KBLicence: CC BY

Cite this

Mirza, A. J., Ali, K., Huwez, F., Taha, A. Y., Ahmed, F. J., Ezzaddin, S. A., Abdulrahman, Z. I., & Lang, C. C. (2022). Contrast Induced Nephropathy: Efficacy of Matched Hydration and Forced Diuresis for prevention inpatients with impaired renal function undergoing coronary procedures - CINEMA Trial. IJC Heart & Vasculature, 39, 1-5. Article 100959. https://doi.org/10.1016/j.ijcha.2022.100959

@article{1c93314a71374c61aba0ce9e75109ca0,

title = "Contrast Induced Nephropathy: Efficacy of Matched Hydration and Forced Diuresis for prevention inpatients with impaired renal function undergoing coronary procedures - CINEMA Trial",

abstract = "Background: Matched hydration and forced diuresis (MHFD) using the RenalGuard device has been shown to reduce contrast induced nephropathy (CIN) following coronary interventions.Aim: To evaluate the potential benefits of a non-automated MHFD protocol compared to current hydration protocol in prevention of CIN in patients with CKD.Methods: A total of 1,205 patients were randomized to either non-automated MHFD group (n = 799) or intravenous hydration control group (n = 406). The MHFD group received 250 ml IV normal saline over 30 min before the coronary procedure followed by 0.5 mg/kg IV furosemide. Hydration infusion rate was manually adjusted to replace the patient's urine output. When urine output rate reached > 300 ml/h, patients underwent coronary procedure. Matched fluid replacement was maintained during the procedure and for 4-hour post-treatment. CIN was defined conventionally as ≥ 25% or ≥ 0.5 mg/dl rise in serum creatinine over baseline.Results: CIN occurred in 121 of 1,205 (10.0%) patients in our study. With respect to the primary outcome, 64 (8.01%) of the MHFD patients developed CIN compared with 57 (14.04%) of the control group (p < 0.001).Conclusions: A non-automated MHFD protocol is an effective and safe method for the prevention of CIN in patients with CKD.",

keywords = "Contrast-induced nephropathy, renal impairment, contrast media, coronary angiography, percutaneous coronary intervention, matched hydration and forced diuresis",

author = "Mirza, {Aram J.} and Kashan Ali and Farhad Huwez and Taha, {Abdulsalam Y.} and Ahmed, {Farman J.} and Ezzaddin, {Shahow A.} and Abdulrahman, {Zana I.} and Lang, {Chim C.}",

note = "{\textcopyright} 2022 The Authors. Published by Elsevier B.V. Funding Statement: The authors received no funding to conduct this study.",

year = "2022",

month = apr,

doi = "10.1016/j.ijcha.2022.100959",

language = "English",

volume = "39",

pages = "1--5",

}

Mirza, AJ, Ali, K, Huwez, F, Taha, AY, Ahmed, FJ, Ezzaddin, SA, Abdulrahman, ZI & Lang, CC 2022, 'Contrast Induced Nephropathy: Efficacy of Matched Hydration and Forced Diuresis for prevention inpatients with impaired renal function undergoing coronary procedures - CINEMA Trial', IJC Heart & Vasculature, vol. 39, 100959, pp. 1-5. https://doi.org/10.1016/j.ijcha.2022.100959

TY - JOUR

T1 - Contrast Induced Nephropathy

T2 - Efficacy of Matched Hydration and Forced Diuresis for prevention inpatients with impaired renal function undergoing coronary procedures - CINEMA Trial

AU - Mirza, Aram J.

AU - Ali, Kashan

AU - Huwez, Farhad

AU - Taha, Abdulsalam Y.

AU - Ahmed, Farman J.

AU - Ezzaddin, Shahow A.

AU - Abdulrahman, Zana I.

AU - Lang, Chim C.

PY - 2022/4

Y1 - 2022/4

N2 - Background: Matched hydration and forced diuresis (MHFD) using the RenalGuard device has been shown to reduce contrast induced nephropathy (CIN) following coronary interventions.Aim: To evaluate the potential benefits of a non-automated MHFD protocol compared to current hydration protocol in prevention of CIN in patients with CKD.Methods: A total of 1,205 patients were randomized to either non-automated MHFD group (n = 799) or intravenous hydration control group (n = 406). The MHFD group received 250 ml IV normal saline over 30 min before the coronary procedure followed by 0.5 mg/kg IV furosemide. Hydration infusion rate was manually adjusted to replace the patient's urine output. When urine output rate reached > 300 ml/h, patients underwent coronary procedure. Matched fluid replacement was maintained during the procedure and for 4-hour post-treatment. CIN was defined conventionally as ≥ 25% or ≥ 0.5 mg/dl rise in serum creatinine over baseline.Results: CIN occurred in 121 of 1,205 (10.0%) patients in our study. With respect to the primary outcome, 64 (8.01%) of the MHFD patients developed CIN compared with 57 (14.04%) of the control group (p < 0.001).Conclusions: A non-automated MHFD protocol is an effective and safe method for the prevention of CIN in patients with CKD.

AB - Background: Matched hydration and forced diuresis (MHFD) using the RenalGuard device has been shown to reduce contrast induced nephropathy (CIN) following coronary interventions.Aim: To evaluate the potential benefits of a non-automated MHFD protocol compared to current hydration protocol in prevention of CIN in patients with CKD.Methods: A total of 1,205 patients were randomized to either non-automated MHFD group (n = 799) or intravenous hydration control group (n = 406). The MHFD group received 250 ml IV normal saline over 30 min before the coronary procedure followed by 0.5 mg/kg IV furosemide. Hydration infusion rate was manually adjusted to replace the patient's urine output. When urine output rate reached > 300 ml/h, patients underwent coronary procedure. Matched fluid replacement was maintained during the procedure and for 4-hour post-treatment. CIN was defined conventionally as ≥ 25% or ≥ 0.5 mg/dl rise in serum creatinine over baseline.Results: CIN occurred in 121 of 1,205 (10.0%) patients in our study. With respect to the primary outcome, 64 (8.01%) of the MHFD patients developed CIN compared with 57 (14.04%) of the control group (p < 0.001).Conclusions: A non-automated MHFD protocol is an effective and safe method for the prevention of CIN in patients with CKD.

KW - Contrast-induced nephropathy

KW - renal impairment

KW - contrast media

KW - coronary angiography

KW - percutaneous coronary intervention

KW - matched hydration and forced diuresis

UR - http://www.scopus.com/inward/record.url?scp=85123887265&partnerID=8YFLogxK

U2 - 10.1016/j.ijcha.2022.100959

DO - 10.1016/j.ijcha.2022.100959

M3 - Article

C2 - 35146119

AN - SCOPUS:85123887265

SN - 2352-9067

VL - 39

SP - 1

EP - 5

JO - IJC Heart & Vasculature

JF - IJC Heart & Vasculature

M1 - 100959

ER -

Contrast Induced Nephropathy: Efficacy of Matched Hydration and Forced Diuresis for prevention inpatients with impaired renal function undergoing coronary procedures - CINEMA Trial

Abstract

Keywords

ASJC Scopus subject areas

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Contrast Induced-Acute Kidney Injury: New Insights into Risk Prediction of Contrast Induced-Acute Kidney Injury and Peri-Procedural Nephroprotective Therapies

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Contrast Induced Nephropathy: Efficacy of Matched Hydration and Forced Diuresis for prevention inpatients with impaired renal function undergoing coronary procedures - CINEMA Trial

Abstract

Keywords

ASJC Scopus subject areas

Access to Document

Other files and links

Fingerprint

Student theses

Contrast Induced-Acute Kidney Injury: New Insights into Risk Prediction of Contrast Induced-Acute Kidney Injury and Peri-Procedural Nephroprotective Therapies

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