Cardiology 2013. Part II.

Humans

Immunoglobulin Fab Fragments/therapeutic use

Kaplan-Meier Estimate

Myocardial Infarction/prevention & control

Myocardial Revascularization/methods

Percutaneous Coronary Intervention/*methods

Platelet Aggregation Inhibitors/therapeutic use

Postoperative Hemorrhage/prevention & control

Prosthesis Failure

Randomized Controlled Trials as Topic

Stents

Notes: Redwood, Simon R

eng

Review

England

2013/01/04 06:00

Eur Heart J. 2013 Feb;34(5):338-44. doi: 10.1093/eurheartj/ehs452. Epub 2013 Jan 2.

URL: http://www.ncbi.nlm.nih.gov/pubmed/23284091

Author Address: BHF Centre of Excellence, King’s College London, St Thomas’ Campus, Westminster Bridge Road, London SE1 7EH, UK. simon.redwood@gstt.nhs.uk

 

 

Reference Type:  Journal Article

Record Number: 941Author: Ribichini, F., Gambaro, A., Pighi, M., Pesarini, G., Ferraro, P. M., Zuppi, C., Baroni, S., Penitente, R., Ferrero, V. and Vassanelli, C.

Year: 2013

Title: Effects of prednisone on biomarkers of tubular damage induced by radiocontrast in interventional cardiology

Journal: J Nephrol

Volume: 26

Issue: 3

Pages: 586-93

Date: May-Jun

Short Title: Effects of prednisone on biomarkers of tubular damage induced by radiocontrast in interventional cardiology

Alternate Journal: Journal of nephrology

ISSN: 1724-6059 (Electronic)

1121-8428 (Linking)

DOI: 10.5301/jn.5000266

Accession Number: 23543480

Keywords: Aged

Angiography

Biological Markers/analysis

Cardiac Imaging Techniques/*methods

Contrast Media/*adverse effects

Female

Glucocorticoids/*therapeutic use

Humans

Kidney Diseases/blood/*chemically induced/*prevention & control/urine

Kidney Tubules/*drug effects

Male

Pilot Projects

Prednisone/*therapeutic use

Abstract: BACKGROUND: Contrast-induced nephropathy (CI-AKI) is a complication of diagnostic/therapeutic hemodynamic procedures in cardiology, which may also cause renal cholesterolinic atheroembolism. Despite the severe clinical impact of these complications, there is no optimal therapy for preventing and treating them. We suggest a short course of high-dose steroids as an effective preventive measure. METHODS: Patients at risk of CI-AKI (n = 38) undergoing cardiovascular procedures were assigned 1:1 to 1 of 2 experimental arms (prednisone+hydration vs. hydration alone). Oral prednisone 1 mg/kg was administered 12 hours before, at 6 am on the same day, and 24 hours following the procedure. Serum creatinine was tested immediately before and again 24-48 hours after the procedure; neutrophil gelatinase-associated lipocalin (NGAL), kidney injury molecule-1 (KIM-1), protein and albumin were assayed in spot urine before and 6 hours after the procedure. RESULTS: NGAL and KIM-1 tended to rise after the procedure, but to a lesser degree in the prednisone group (delta NGAL: hydration = +128%, prednisone = +46%; p = 0.26; delta KIM-1: hydration = +99%, prednisone = +11%; p = 0.02). Proteinuria and albuminuria decreased significantly in the prednisone group. In 5 patients developing CI-AKI, their delta NGAL and delta KIM-1 did not differ from the values seen in patients without CI-AKI. Hypertension, peripheral arteriopathy and use of low-dose aspirin or diuretics were positive predictors of baseline NGAL, while treatment with calcium channel blockers and statins were negative predictors. Statins were negative predictors of baseline KIM-1. CONCLUSIONS: A short course of prednisone reduces the procedure-induced changes in biomarkers of renal tubular damage. This study suggests that steroids had a tubule-protecting effect.

Pages: 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 100 101 102 103 104 105 106 107 108 109 110 111 112 113 114 115 116 117 118 119 120 121 122 123 124 125 126 127 128 129 130 131 132 133 134 135 136 137 138 139 140 141 142 143 144 145 146 147 148 149 150 151 152 153 154 155 156 157 158 159 160 161 162 163 164 165 166 167 168 169 170 171 172 173 174 175 176 177 178 179 180 181 182 183 184 185 186 187 188 189 190 191 192 193 194 195 196 197 198 199 200 201 202 203 204 205