Abstract
Background: Contrast-induced nephropathy (CIN) is a common cause of acute kidney injury and is associated with significant morbidity and mortality even if transient or successfully treated. The preventive measures currently available have failed to show significant efficacy. Selenium, which is involved in anti-oxidative reactions, might have protective effects against CIN. Methods: 237 patients undergoing coronary angiography or intervention were randomly assigned to receive placebo (n=120) or selenium (200 mcg daily on the pre-procedural day, procedural day, and the first post-procedural day) (n=117). Serum creatinine was measured before and two days after the procedure. The primary endpoint was the occurrence of CIN within forty-eight hours. Results: Baseline characteristics were not different between the groups. CIN occurred in 13 (11.1%) patients in the selenium group and in 23 (19.2%) in the placebo group (odds ratio (or) 95% confidence interval (CI): 1.72 (0.92-3.24), p value=0.084). Selenium intake was significantly associated with lower rates of CIN in the males (or (95% CI): 2.33 (1.10-5.48), p value=0.04), hypertensive patients (or (95% CI): 2.69 (1.12-7.53), p value=0.04), those with a left ventricular ejection fraction <50% (or (95% CI): 5.38 (1.26-22.9), p value=0.008), and those who underwent percutaneous coronary interventions (or (95% CI): 1.98 (1.01-3.99), p value=0.04). Conclusion: Selenium, as an antioxidant, might decrease the occurrence of CIN, especially in high-risk patients undergoing coronary angiography or percutaneous coronary intervention. Nevertheless, routine recommendation of selenium to these patients needs further investigations.
Highlights
Nowadays, contrast agents are increasingly employed in various diagnostic and therapeutic techniques
Contrast-induced nephropathy (CIN) occurrence, even if transient and self-limited or successfully treated, is allied with poor outcomes in patients scheduled for coronary angiography and percutaneous coronary interventions (PCI) [6,7,8,9,10]
Patients were considered eligible for enrolment if they were over 18 years of age with chronic stable angina or acute coronary syndrome with classic indications for coronary angiography or PCI
Summary
Contrast agents are increasingly employed in various diagnostic and therapeutic techniques. Contrast-induced nephropathy (CIN) is one of the most important complications of contrast agents and ranges in severity from mild to severe and even life-threatening [1,2]. Core elements that are intertwined in the pathophysiology of CIN include direct toxicity of iodinated contrast to nephrons, micro showers of athero-emboli to the kidneys, and contrast- and atheroemboli induced intra-renal vasoconstriction [3,4]. CIN occurrence, even if transient and self-limited or successfully treated, is allied with poor outcomes in patients scheduled for coronary angiography and PCI [6,7,8,9,10]. Contrast-induced nephropathy (CIN) is a common cause of acute kidney injury and is associated with significant morbidity and mortality even if transient or successfully treated. Selenium, which is involved in anti-oxidative reactions, might have protective effects against CIN
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