The Risk Factors Of Contrast Induced Nephropathy And The Function Of Hydration Therapy To Patients With Coronary Angiography

Backgrounds The morbidity of contrast induced nephropathy(CIN) increases year by year, which also leads to higher mortality and hospitality. The risk factors and preventive measure methods have been discussed extensively these days. Nowadays, the risk factors of CIN include:chronic renal failure with low renal function, diabetes mellitus, the volume of contrast media used, congestive heart failure and so on. Hydration is now considered as one of the most effective methods of CIN prevention.Object Analysis the morbidity and the clinical risk factors of CIN. Discuss the effect of hydration in protecting patients'acute and long-term renal function.Method This is a single center, prospective study.650 patients with selective coronary angiography(CAG) were included into the cohort from February to December in 2009, estimated their GFR by MDRD formula according to the blood serum creatinine. The patients with eGFR up to 60ml/min/1.73 m2 were allocated into non-hydration group, and those eGFR below 60ml/min*1.73 m2 were listed into the hydration group. The patients admitted from February to July 2009 were received saline hydration and those from August to December were received 5% sodium bicarbonate hydration. The hydration titrated according to patients' weight, and normal saline or sodium bicarbonate were intravenous at the speed of kg/h during the procedure and within 6 hours after CAG The baseline data of patients and the blood serum creatinine before the CAG,within 48 hours after the CAG,half year after the CAG were recorded in the database. Then SPSS software was used to analyze the morbidity and clinical risk factors of CIN..Results 595 patients of 650 were collected. (the exclusion were:49 without postoperative serum creatinine; 2 accepted contrast media injections before CAG,3 dead,1 accepted hemodialysis). The morbidity of CIN in non-hydration group (n=543) is 3.32%; there was no CIN happened in hydration group (n=52). In Logistic regression,we found the clinical risk factors of CIN included:reduced eGFR, hypertension, ARB/ACE-I administration before angiography for more than one month, female and the age. It is useful of hydration to protect acute and long-term renal function.Future It leads to further research to the long-term kidney protection with hydration.