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The effect of withdrawal of ACE inhibitors or angiotensin receptor blockers prior to coronary angiography on the incidence of contrast-induced nephropathy.
The effect of withdrawal of ACE inhibitors or angiotensin receptor blockers prior to coronary angiography on the incidence of contrast-induced nephropathy.
- Source :
-
International urology and nephrology [Int Urol Nephrol] 2008; Vol. 40 (3), pp. 749-55. Date of Electronic Publication: 2008 Apr 26. - Publication Year :
- 2008
-
Abstract
- Background: The effect of continuing or discontinuing chronic angiotensin-converting enzyme inhibitor (ACEI) or angiotensin receptor blocker (ARB) therapy prior to coronary angiography on the incidence of contrast-induced nephropathy (CIN) is not clear. We undertook a randomized trial to evaluate the effect of withdrawing ACEIs or ARBs 24 h prior to coronary angiography on the incidence of CIN associated with coronary angiography.<br />Methods: A total of 220 patients with chronic kidney disease (CKD) stages 3-4 (glomerular filtration rate 15-60 ml/min/1.73 m2) on ACEI or ARB therapy were randomized before angiography to either ACEI/ARB continuation group or discontinuation group. A third group of patients with CKD stages 3-4 but not on angiotensin blockade therapy were also followed. The primary outcome measure was the incidence of CIN defined by a rise in serum creatinine by 25% or 0.5 mg/dl (44 micromol/l) from baseline.<br />Results: There was no statistically significant difference in the incidence of CIN between the three groups (P=0.66). The incidences were 6.2%, 3.7%, and 6.3% for the continuation, discontinuation, and angiotensin blockade naïve group, respectively. There was also no significant difference found between the groups in mean serum creatinine and glomerular filtration rate values at baseline and post contrast administration.<br />Conclusion: Withholding ACEIs and ARBs 24 h before coronary angiography does not appear to influence the incidence of CIN in stable patients with CKD stages 3-4.
- Subjects :
- Aged
Analysis of Variance
Creatinine blood
Female
Humans
Incidence
Male
Angiotensin II Type 1 Receptor Blockers administration & dosage
Angiotensin-Converting Enzyme Inhibitors administration & dosage
Contrast Media adverse effects
Coronary Angiography
Kidney Diseases chemically induced
Kidney Failure, Chronic complications
Subjects
Details
- Language :
- English
- ISSN :
- 0301-1623
- Volume :
- 40
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- International urology and nephrology
- Publication Type :
- Academic Journal
- Accession number :
- 18438718
- Full Text :
- https://doi.org/10.1007/s11255-008-9368-1