Effect of hydration improvement to prevent contrast induced nephropathy

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Objective To discuss the effect of hydration improvement to prevent contrast induced nephropathy (CIN).Methods 160 patients with CIN of high risks who had received coronary arteriongraphy were chosen and Richard Doll was used to divide them into the control group and the improvement group,each with 80 cases.The control group had 0.9％ NaCl for 24 h with the speed of 1.5ml/kg · h,while the improvement group had 0.9％ NaCl for 24 h and their fluid volume and speed was adjusted according to patients'urine volume,recessive loss,blood pressure,heart rate and peripheral venous pressure to maintain dynamic equilibrium of blood volume.Effect in two groups was compared.Results There was no statistically significant difference of preoperative infusion volume and postoperative drinking volume in 24 hours between two groups (P ＞0.05).Postoperative 24 h infusion volume and urine volume were (2 314.21 ±295.03) and (1 918.25 ± 297.58) in the control group,(2 781.69 ± 254.72) and (2 245.50 ± 278.31) in the improvement group,and the differences were statistically significant (t =10.727,7.184,respectively; P ＜ 0.01).There was no statistically significant difference of preoperative NT-ProBNP between two groups (P ＞ 0.05).Postoperative NT-ProBNP was (2882.16 ±2 724.24)ng/ml in the control group and (1 507.16 ± 1 473.84) ng/ml in the improvement group,and the difference was statistically significant (Z =1.975,P ＜ 0.05).Incidence rate of CIN was 12.5％ in the control group and 2.5％ in the improvement group,and the difference was statistically significant (x2 =5.766,P =0.016).Scr in the blood 24,48 and 72 hours after surgery was higher in CIN patients than that in non-CIN patients.NGAL in urine was higher after the surgery than before,and reached its peak during 24-48 hours,24 hours ahead of Scr increase.There was no statistically significant difference of acute lung edema,urinary retention and hospitalization time between two groups (P ＞ 0.05).Neither groups had cases of hemodialysis or death.Conclusions Hydration improvement can prevent CIN as well as protect patients' heart function. Key words: Contrast induced nephropathy Hydration solution; Heart function protection