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Forced Diuresis with Matched Isotonic Intravenous Hydration Prevents Renal Contrast Media Accumulation

The accumulation of contrast media in the kidneys might lead to contrast-induced acute kidney injury. In this prospective, controlled observational study, we aimed to evaluate whether forced diuresis with matched isotonic intravenous hydration prevents the accumulation of contrast media in the kidne...

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Autores principales: Ben-Haim, Yael, Chorin, Ehud, Hochstadt, Aviram, Ingbir, Merav, Arbel, Yaron, Khoury, Shafik, Halkin, Amir, Finkelstein, Ariel, Banai, Shmuel, Konigstein, Maayan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8837041/
https://www.ncbi.nlm.nih.gov/pubmed/35160335
http://dx.doi.org/10.3390/jcm11030885
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author Ben-Haim, Yael
Chorin, Ehud
Hochstadt, Aviram
Ingbir, Merav
Arbel, Yaron
Khoury, Shafik
Halkin, Amir
Finkelstein, Ariel
Banai, Shmuel
Konigstein, Maayan
author_facet Ben-Haim, Yael
Chorin, Ehud
Hochstadt, Aviram
Ingbir, Merav
Arbel, Yaron
Khoury, Shafik
Halkin, Amir
Finkelstein, Ariel
Banai, Shmuel
Konigstein, Maayan
author_sort Ben-Haim, Yael
collection PubMed
description The accumulation of contrast media in the kidneys might lead to contrast-induced acute kidney injury. In this prospective, controlled observational study, we aimed to evaluate whether forced diuresis with matched isotonic intravenous hydration prevents the accumulation of contrast media in the kidneys of patients undergoing cardiac interventional procedures. We compared the intensity of contrast media accumulation as observed in nephrograms following these procedures, with and without peri-procedural controlled renal flushing. The study group consisted of 25 patients with impaired renal function treated with the RenalGuard system. The two control groups included 25 patients with normal kidney function and 8 patients with impaired renal function undergoing similar procedures with routine pre-procedural hydration, but without controlled renal flushing. Renal contrast media accumulation at the end of each procedure was scored by blinded cardiologists. The renal contrast accumulation score (CAS) in the study group was significantly lower, with a median score of 0 (IQR (0–0)) compared with 1.5 (IQR (1–2)) in the normal renal function control group and 1 (IQR (0.38–1.62)) in the impaired renal function control group (p < 0.001 and 0.003, respectively). In a multivariate analysis of CAS, RenalGuard treatment was independently associated with lower CAS compared to both control groups. In conclusion, RenalGuard use prevents renal contrast accumulation in patients with impaired renal function undergoing cardiac procedures with intra-arterial contrast media injection.
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spelling pubmed-88370412022-02-12 Forced Diuresis with Matched Isotonic Intravenous Hydration Prevents Renal Contrast Media Accumulation Ben-Haim, Yael Chorin, Ehud Hochstadt, Aviram Ingbir, Merav Arbel, Yaron Khoury, Shafik Halkin, Amir Finkelstein, Ariel Banai, Shmuel Konigstein, Maayan J Clin Med Article The accumulation of contrast media in the kidneys might lead to contrast-induced acute kidney injury. In this prospective, controlled observational study, we aimed to evaluate whether forced diuresis with matched isotonic intravenous hydration prevents the accumulation of contrast media in the kidneys of patients undergoing cardiac interventional procedures. We compared the intensity of contrast media accumulation as observed in nephrograms following these procedures, with and without peri-procedural controlled renal flushing. The study group consisted of 25 patients with impaired renal function treated with the RenalGuard system. The two control groups included 25 patients with normal kidney function and 8 patients with impaired renal function undergoing similar procedures with routine pre-procedural hydration, but without controlled renal flushing. Renal contrast media accumulation at the end of each procedure was scored by blinded cardiologists. The renal contrast accumulation score (CAS) in the study group was significantly lower, with a median score of 0 (IQR (0–0)) compared with 1.5 (IQR (1–2)) in the normal renal function control group and 1 (IQR (0.38–1.62)) in the impaired renal function control group (p < 0.001 and 0.003, respectively). In a multivariate analysis of CAS, RenalGuard treatment was independently associated with lower CAS compared to both control groups. In conclusion, RenalGuard use prevents renal contrast accumulation in patients with impaired renal function undergoing cardiac procedures with intra-arterial contrast media injection. MDPI 2022-02-08 /pmc/articles/PMC8837041/ /pubmed/35160335 http://dx.doi.org/10.3390/jcm11030885 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Ben-Haim, Yael
Chorin, Ehud
Hochstadt, Aviram
Ingbir, Merav
Arbel, Yaron
Khoury, Shafik
Halkin, Amir
Finkelstein, Ariel
Banai, Shmuel
Konigstein, Maayan
Forced Diuresis with Matched Isotonic Intravenous Hydration Prevents Renal Contrast Media Accumulation
title Forced Diuresis with Matched Isotonic Intravenous Hydration Prevents Renal Contrast Media Accumulation
title_full Forced Diuresis with Matched Isotonic Intravenous Hydration Prevents Renal Contrast Media Accumulation
title_fullStr Forced Diuresis with Matched Isotonic Intravenous Hydration Prevents Renal Contrast Media Accumulation
title_full_unstemmed Forced Diuresis with Matched Isotonic Intravenous Hydration Prevents Renal Contrast Media Accumulation
title_short Forced Diuresis with Matched Isotonic Intravenous Hydration Prevents Renal Contrast Media Accumulation
title_sort forced diuresis with matched isotonic intravenous hydration prevents renal contrast media accumulation
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8837041/
https://www.ncbi.nlm.nih.gov/pubmed/35160335
http://dx.doi.org/10.3390/jcm11030885
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