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)

Research output: Contribution to journalArticlepeer-review

2 Citations (Scopus)
26 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 languageEnglish
Article number100959
Pages (from-to)1-5
Number of pages5
JournalIJC Heart & Vasculature
Volume39
Early online date1 Feb 2022
DOIs
Publication statusPublished - Apr 2022

Keywords

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

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