Acute Renal Failure, Chronic Renal Failure, Contrast-induced Nephropathy
Conditions
Keywords
contrast-induced nephropathy, prevention, renal failure, cardiac angiogram
Brief summary
Patients with pre-existing kidney disease are at high risk of acute renal failure when exposed to radio-contrast dyes, for example during a cardiac angiogram. The investigators hypothesize that an infusion of saline + furosemide + mannitol will reduce rates of contrast-induced nephropathy when compared with saline infusion controls.
Detailed description
Patients with pre-existing kidney disease are at high risk of acute renal failure when exposed to radio-contrast dyes, for example during a cardiac angiogram. We hypothesize that an infusion of saline + furosemide + mannitol will reduce rates of contrast-induced nephropathy when compared with saline infusion controls. We define an episode of contrast nephropathy using the conventional often published definition of a 25% relative increase in serum creatinine OR a 44 umol absolute increase in serum creatinine within 48 hours of contrast exposure.
Interventions
DRUGintravenous saline hydration + mannitol + furosemide
500 mls half-normal saline + 25g mannitol + 100 mg furosemide
DRUGintravenous saline hydration
500 mls half-normal saline
Sponsors
Alberta Heritage Foundation for Medical Research
University of Alberta
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
QUADRUPLE (Subject, Caregiver, Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
21 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* age \> 21 years * serum creatinine \> 150 umol/L * able and willing to provide informed consent
Exclusion criteria
* known hypersensitivity to contrast, furosemide, or mannitol * unable to tolerate a fluid load (e.g., acute pulmonary edema) * ESRD, on dialysis * previous enrollment in this study or previous contrast administration with the last 2 weeks * refusal by treating physician
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Proportion of patients that develop contrast-induced nephropathy after cardiac angiography | Within 48 hours of angiogram |
Secondary
| Measure | Time frame |
|---|---|
| Safety of the intervention based on transfer to ICU, need for dialysis, or death | During hospitalization episode |
| Adverse clinical events and measures of renal function | 6 weeks post-angiogram |
| Health related quality of life | 6 weeks post-angiogram |
| Subgroup analyses based on (a) diabetes; (b) amount of contrast; and (c) baseline creatinine | Within 48 hours of angiogram |
Countries
Canada
Outcome results
None listed