Short- and long-term renal outcomes of immediate prophylactic hemodialysis after cardiovascular catheterizations in patients with severe renal insufficiency

被引:17
作者
Hsieh, YC
Ting, CT
Liu, TJ
Wang, CL
Chen, YT
Lee, WL
机构
[1] Taichung Vet Gen Hosp, Div Cardiol, Dept Med, Taichung 407, Taiwan
[2] Taichung Vet Gen Hosp, Div Nephrol, Dept Med, Taichung 407, Taiwan
[3] Natl Yang Ming Univ, Sch Med, Inst Clin Med, Taipei 112, Taiwan
[4] Natl Yang Ming Univ, Sch Med, Dept Med, Taipei 112, Taiwan
[5] Chung Shan Med Univ, Dept Med, Taichung, Taiwan
关键词
contrast medium; hemodialysis; angiography;
D O I
10.1016/j.ijcard.2004.03.052
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background: The short- and long-term effects of prophylactic hemodialysis (HD) immediately after cardiovascular catheterizations on renal function in patients with severe baseline renal insufficiency remain unknown though previous studies reported non-beneficial very-short-term effect in less severe patients. Methods and results: Patients who had pre-procedural serum creatinine (Scr) between 2.5 and 5.5 mg/dl were retrospectively studied. Twenty of them (14 M/6 F, aged 69 2 years) had received prophylactic HD after radiocontrast exposure and constituted the HD group. Another 20 patients were case-matched to the baseline demographics of the HD group and served as the non-HD group. The baseline Scr were 3.9 +/- 0.2 and 3.5 +/- 0.2 mg/dl, respectively (p=NS). Although the Scr at 3 months was significantly higher in the HD group (4.3 +/- 0.3 vs. 3.4 +/- 0.2 mg/ dl, p=0.02), the absolute and percentage increments from baseline to 3 months (0.4 +/- 0.2 vs. 0.0 +/- 0.2 mg/dl, p=NS, and 11 +/- 5% vs. 1 +/- 7%, p =NS, respectively) and 6 months (0. 6 +/- 0.3 vs. 0.4 +/- 0.4 mg/dl, p =NS, and 18 +/- 8% vs. 8 +/- 10%, p =NS, respectively) were not statistically different. Patients who developed end-stage renal disease requiring permanent HD at 1 year were also similar in both groups (four vs. three, respectively, p=NS). Conclusions: Our study confirmed that prophylactic HD immediately after contrast media administration in catheterizations failed to affect the short- and long-term renal and clinical outcomes even in patients with severe baseline renal insufficiency. (c) 2004 Elsevier Ireland Ltd. All rights reserved.
引用
收藏
页码:407 / 413
页数:7
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