Effect of a Contrast Agent on Long-Term Renal Function and the Efficacy of Prophylactic Hemodiafiltration

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Background There have been few studies regarding the effect of contrast agent on long-term renal function and, moreover, there are still many uncertainties regarding the efficacy of prophylactic hemodiafiltration (HDF) for contrast-induced nephropathy. Methods and Results Patients with heart disease and a serum creatinine level (Scr) of less than 1.2mg/dl were classified as Group N (20 patients), those with Scr of at least 1.2mg/d1 but less than 2.0mg/dl were classified as Group D1 (10 patients without HDF) and D2 (15 patients with HDF), respectively. For each group, a linear regression of 1/Scr was extrapolated using Scr measured more than 3 times during each period that was longer than 3 months before and after use of a contrast agent, and the slopes (constant k) thereof were compared. To remove the contrast agent, HDF was performed for 2h. Group D1 showed a significant decrease in the k after use of the contrast agent (p<0.05). Conclusion Use of a contrast agent is an independent factor that promotes chronic renal insufficiency and prophylactic HDF was found to effectively improve the long-term outcome of decreased renal function.
2008-02-20