Abstract 1690: Prevention of Contrast-Induced Nephropathy by Carperitide

Abstract

Introduction: Contrast-induced nephropathy (CIN) remains as a common complication of angiographic procedure. Carperitide, an antagonist of secretion of rennin, aldosterone and vasopressin with natriuretic effects, has renal protective effects. Hypothesis: Carperitide may be effective in preventing CIN. Methods: We prospectively studied 170 consecutive patients with chronic renal failure (serum creatinine(SCr) concentration >1.3mg/dl)who underwent coronary angiography. The patients were randomly assigned to either 1.3ml/kg/hr of lactated Ringer’s infusion plus carperitide 0.042μg/kg/min (Carperitide group N=86) or lactated Ringer’s infusion alone (Control group N=84). The administration was initiated 6 hours prior to the procedure and continued for 48 hours after angiography. The concentration of SCr and cystatin C were measured at baseline, 24 hours, 48 hours, 1 week, and 1 month following the angiography. Results: The SCr concentration increased gradually up to one month in the Control group, whereas remained almost unchanged in the Carperitide group (p=0.001 for the trend, Figure ). The cystatin C concentration also showed the same trend (p=0.013 for the trend, Figure ). When CIN was defined as an increase of ≥0.5 mg/dl or ≥25% in the SCr at 48 hours after angiography, CIN developed in 7 of 84 patients (8%) in the Control group and 1 of 86 patients (1%) in the Carperitide group (P=0.047). Multivariate analysis disclosed that carperitide infusion (OR 0.097, P=0.041) and quantity of contrast media (OR 14.06, P=0.004) were significantly related to the development of CIN. Conclusions: Carperitide is effective in preventing CIN in patients with chronic renal failure.