Continuous hemofiltration for prevention of contrast induced nephropathy in patients with advanced chronic kidney disease after percutaneous coronary intervention
10.3969/j.issn.1004-8812.2014.09.008
- VernacularTitle:严重肾功能不全患者冠状动脉介入治疗后行血液滤过预防对比剂肾病的发生
- Author:
Kun WANG
;
Biao XU
;
Lian WANG
;
Jie SONG
;
Wei HUANG
;
Ling GAO
;
Jingmei ZHANG
- Publication Type:Journal Article
- Keywords:
Severe renal insufficiency;
Percutaneous coronary intervention;
Hemodialysis;
Contrast induced nephropathy
- From:
Chinese Journal of Interventional Cardiology
2014;(9):578-581
- CountryChina
- Language:Chinese
-
Abstract:
Objective To assess the value of hemofiltration in the prevention of contrast induced nephropathy(CIN) post percutaneous coronary intervention(PCI) in severe chronic kidney disease stages(CKD) patients. Methods We evaluated 30 CKD patients who underwent PCI followed by bedside hemofiltration. We measured serum creatinine levels before PCI, 24 hours, 72 hours, and one week after PCI, and calculated creatinine clearance(CrCl) according to Cockcroft and Gault equation.We observed the incidence of CIN, and the short term clinical efficacy of hemofiltralion. Results The average age of the 30 patients was (72.87 ± 8.71) years old, with 21 (70%) male patients. The stages of CKD among the patients included CKD 3 (3 patients, 10%), CKD 4 (20 patients, 66.7%) and CKD 5 (7 patients, 23.3%). The average duration of hemofiltration was (7.5±4.1) hours. Serum creatinine before PCI, 24 hours, 72 hours and 1 week after PCI was (498.7±143.7)μmol/L, (353.2±128.0)μmol/L, (450.0±132.2)μmol/L, (488.0±145.7)μmol/L respectively,and CrCl was (20.3±10.2) ml/min, (36.5±14.3) ml/min, (28.3±10.4) ml/min, (21.0±10.3) ml/min respectively. There was no CIN. Mean follow-up was (3.1 ± 2.6) months. There was no new cardiovascular events, and no new patients need to rely on long term hemodialysis. Conclusions For patients with severe renal insufficiency, hemofiltration may reduce the incidence of CIN, It is an alternative preventive measures to prevent CIN.
