Study On The Preventive Efficacy Of Different Hydration Against The Kidney Injury Induced By The Iodine Contrast Media In Contrast-enhanced CT

Objective:In order to provide the basis for the choice of hydration we have investigated the preventive efficacy of oral hydration and intravenous hydration on kidney injury resulting from non-ionic iodine contrast agent in group A(without diabetes and hypertension)and group B(with diabetic or hypertension)patients undergoing contrast-enhanced computed tomography.Methods:According to the inclusion and exclusion criteria,126 patients who were undertaken contrast-enhanced computed tomography in the second hospital of Shanxi Medical College from September 2015 to January 2017 were selected.64 patients without diabetes and hypertension were selected as the group A,while 62 patients with diabetes or hypertension were selected as the group B.Patients in group A were randomly divided into group A1(n=31)who were receiving oral hydration with warm boiled water or mineral water and group A2(n=33)who were receiving intravenous hydration with isotonic solution(0.9%NaCl).Patients in group B were randomly divided into group B1(n=32)who were receiving oral hydration with warm boiled water or mineral water and B2(n=30)who were receiving intravenous hydration with isotonic solution(0.9% NaCl).The test results of renal functional index of all patients including the α1microglobulin,β2microglobulin,cystatin-C,serum creatinine and blood urea nitrogen before contrast-enhanced computed tomography and the 1st,3rd,7th day after contrast-enhanced computed tomography.The all renal functional index were collected and the incidence of nephropathy induced by contrast agent were recorded.We compared the changes in renal functional index before contrast-enhanced computed tomography and at the 1st,3rd,7th day after contrast medium administration in group A1 and A2.Moreover,the changes in the renal functional index in the corresponding time(before and at the 1st,3rd,7th day after contrast medium administration)between group A1 and A2 were compared.Subsequently,we compare the renal functional index before contrast medium administration and at the 1st,3rd,7th day after contrast medium administration in group B1 and B2.Furthermore,the changes in the renal functional index in the corresponding time(before and at the 1st,3rd,7th day after contrast medium administration)between group B1 and B2 were compared.The rate of contrast induced nephropathy were compared in group A1 and A2,B1 and B2.SPSS20.0 statistical software is employed for the data analysis,the used methods covering t-test,variance and chi square test on relevant data.When the value of P was less than 0.05,the difference was statistically significant.Results :1.There were no statistical differences of all renal functional index levels at the 1st,3rd,7th day after contrast medium administration in comparison with those before contrast medium administration in group A1(P>0.05).2.There were no statistical differences of all renal functional index levels at the 1st,3rd,7th day after contrast medium administration in comparison with those before contrast medium administration in group A2(P>0.05).3.There were no statistical differences of all renal functional index levels in the corresponding time(before and at the 1st,3rd,7th day after contrast medium administration)between group A1 and A2(P>0.05).4.There were no statistical differences of all renal functional index levels at the 1st,3rd,7th day after contrast medium administration compared to those before contrast medium administration in group B1(P>0.05).5.There were no statistical differences of all renal function index levels at the 1st,3rd,7th day after contrast medium administration compared to those before contrast medium administration in group B2(P>0.05).6.There were no statistical differences of all renal function index levels in the corresponding time(before and at the 1st,3rd,7th day after contrast medium administration)between group B1 and B2(P>0.05).7.The incidence of contrast induced nephropathy in group A1 was 3.2%(1/31),and the incidence of contrast induced nephropathy in group A2 was 0(0/33).There were no statistical difference between the two groups(χ2=1.081,P=0.484).8.The incidence of contrast induced nephropathy in group B1 was 0(0/32),and theincidence of contrast induced nephropathy in group B2 was 3.3%(1/30).There were no statistical difference between the two groups(χ2=1.084,P=0.484).Conclusions:1.The preventive efficiency of oral hydration and intravenous hydration on kidney injury resulting from non-ionic iodine is the same for the patients with normal renal function undergoing contrast-enhanced computed tomography.2.The oral hydration is simpler,cheaper and more comfortable than the intravenous hydration,which is worth using widely in contrast-enhanced computed tomography.