Central Venous Pressure-Guided Hydration May Reduce CIN
Reduced risk of contrast-induced nephropathy with no increase in acute heart failure.
(HealthDay News) -- For patients with chronic kidney disease (CKD) and congestive heart failure (CHF) undergoing coronary procedures, central venous pressure (CVP)-guided hydration is associated with reduced risk of contrast-induced nephropathy (CIN), according to a study published online in JACC: Cardiovascular Interventions.
Geng Qian, MD, from the Chinese People's Liberation Army General Hospital in Peking, and colleagues conducted a prospective comparative trial involving 264 patients with CKD and CHF undergoing coronary procedures. Patients were randomized to CVP-guided hydration or standard hydration (132 patients in each group). The hydration infusion rate was dynamically adjusted according to CVP level every hour in the CVP-guided group.
The researchers found that the total mean volume of isotonic saline administered was significantly higher in the CVP-guided hydration group than the control group (P < 0.001). CIN occurred less often in the CVP-guided hydration group (15.9 versus 29.5% in the control group; P = 0.006). There was no difference between the groups in the incidences of acute heart failure during the hydration (3.8 versus 3.0%; P = 0.500).
"CVP-guided fluid administration can safely and effectively reduce the risk of CIN in patients with CKD and CHF," the authors write.
- Qian G, Fu Z, Guo J, Cao F, and Chen Y. Prevention of Contrast-Induced Nephropathy by Central Venous Pressure–Guided Fluid Administration in Chronic Kidney Disease and Congestive Heart Failure Patients. J Am Coll Cardiol Intv. doi:10.1016/j.jcin.2015.09.026.
- Solomon R. Improving Intravenous Fluid Therapy for Prevention of Contrast-Induced Nephropathy How to Give More Without Causing Heart Failure. J Am Coll Cardiol Intv. doi:10.1016/j.jcin.2015.10.014.