2016 年 10 巻 4 号 p. 183-189
Objective: Contrast-induced acute kidney injury is more likely to result in various morbidities than to develop into renal dysfunction. To prevent acute kidney injury from occurring, we performed hydration therapy and administered reduced contrast medium concentrations for patients with preexisting high-risk chronic kidney disease (CKD; stage 3 or 4). The objective of this study was to evaluate the effectiveness of these procedures.
Methods: Fifty-one sites underwent carotid artery stenting. We divided the patients into two groups by CKD stage (group A: stage 1–2, group B: stage 3–4) and reduced the dose of contrast medium during the intervention for the patients in group B. Furthermore, intravenous hydration peri-intervention was performed in patients with CKD stage 3b or 4. The differences in the estimated glomerular filtration rate (eGFR) between before and after therapy, were retrospectively assessed.
Results: There was a significant difference in the two groups in terms of the dose of contrast medium administered (group A: 58.3 ml ± 18.5 ml, group B: 32.8 ml ± 21.5 ml, p <0.01). Moreover, there was a significant difference between the two groups in terms of the difference in eGFR before and after the intervention (group A: –4.87 ml ± 8.23 ml, group B: 1.03 ml ± 6.07 ml, p <0.05).
Conclusion: Our findings indicate the effectiveness of a reduction in the dose contrast medium and hydration for the prevention of renal dysfunction in high-risk CKD patients undergoing carotid artery stenting.