Incidence of contrast-induced nephropathy with volume supplementation - Insights from a large cohort

Objective: The present study was performed to determine the effect of combined intravenous and oral volume supplementation on the incidence of contrast-induced nephropathy (CIN) in patients undergoing percutaneous coronary intervention (PCI). Subjects and Methods: Consecutive patients (n = 958) receiving iomeprol 350 during PCI were evaluated prospectively for the development of CIN. All patients received protocol-defined intravenous and oral volume supplementation. CIN was defined as an increase in serum creatinine of at least 44 mu mol/l within 48 h. Results: Of the 958 patients enrolled in the study, 147 (15%) were diabetic and 107 (11%) had stage III renal disease. The average baseline glomerular filtration rate was 88 +/- 25 ml/min/1.73 m(2). During the intervention an average of 238 +/- 86 ml of contrast medium was administered. CIN developed in 13 of 958 (1.4%; 95% confidence interval 0.6-2.1%) patients. The incidence of CIN was low even in predefined risk subgroups ( women: 2.4%, diabetics: 2.7%, patients with stage III kidney disease: 6.5%). Conclusions: The incidence of CIN is low when pre-procedural fluid volume supplementation is used. Copyright (c) 2008 S. Karger AG, Basel.