The Role of Xuefu Zhuyu Decoction in Prevention of Contrast-Induced Nephropathy after Percutaneous Coronary Intervention

Jingjing Zhao,Fang Peng,Huahua Liu,Yangbo Xing,Weiliang Tang,Jiahao Peng,Buyun Xu

doi:10.1155/2020/5419016

Abstract

Objective This study aimed to investigate the effect of Xuefu Zhuyu decoction on preventing contrast-induced nephropathy (CIN) after percutaneous coronary intervention (PCI). Methods A total of 256 patients undergoing selective PCI for coronary artery disease were consecutively enrolled and randomly divided into two groups: Group A (n = 126) and Group B (n = 130). Before and after PCI, all patients routinely received antiplatelet aggregation therapy, antilipidemic therapy, and hydration therapy. Besides routine therapy, patients in Group B received Xuefu Zhuyu decoction from 3 days before PCI to 3 days after PCI. Serum creatinine (Scr), estimated glomerular filtration rate (eGFR), superoxide dismutase (SOD), and malondialdehyde (MDA) were measured, respectively, at baseline (72 h before PCI) and at 24, 48, and 72 h after PCI. Results Compared with Group A, Group B presented a lower fluctuation of SCr and eGFR (P < 0.01). The incidence of CIN was less in Group B. According to the definition, CIN occurred in 5 patients (2.0%) in the intervention group and 5 (4.0%) in the control group (P=0.167). In terms of oxidative stress, Group B had a lower MDA (P < 0.05), but a higher SOD (P < 0.05). Conclusions Compared with the control group, Xuefu Zhuyu decoction intervention therapy increased the level of SOD and reduced MDA. The Xuefu Zhuyu decoction intervention group presented a higher level of eGFR at 24, 48, and 72 h after PCI in patients with coronary heart disease and a lower level of Scr. The results are propitious to prove that Xuefu Zhuyu decoction might play an antioxidative stress role in the prevention of CIN after PCI.

Highlights

Contrast-induced nephropathy (CIN) is defined as an increase in serum creatinine beyond 44.2 μmol/L (0.5 mg/dl) or 25% of the baseline within 72 h after contrast medium administration without other factors [1,2,3,4]
The present study was the first study evaluating the role of Xuefu Zhuyu decoction in prevention of CIN. e main findings were as follows: (i) Xuefu Zhuyu decoction was associated with less SCr and higher estimated glomerular filtration rate (eGFR) after percutaneous coronary intervention (PCI); (ii) Xuefu Zhuyu decoction contributed to higher superoxide dismutase (SOD) and lower MDA, which are the markers of oxidative stress that might play an important role in CIN; (iii) oxidative stress played an important role in the pathogenesis of CIN
Contrast medium significantly attenuated renal SOD and GSH levels and increased MDA levels. ey found that contrast mediuminduced indicators of oxidative stress in the kidney and the CIN-induced changes could be blocked through their pretreatment

Summary

Introduction

Contrast-induced nephropathy (CIN) is defined as an increase in serum creatinine beyond 44.2 μmol/L (0.5 mg/dl) or 25% of the baseline within 72 h after contrast medium administration without other factors [1,2,3,4]. A large amount of contrast media is needed during the procedure, and a dose-dependent relation between contrast media volume and CIN in patients undergoing angiography had been reported [6]. CIN is a common complication during the periprocedural period with an incidence rate ranging from 5% to 25% [7, 8]. Besides the high incidence of CIN [9, 10], it is associated with adverse outcomes, which has become one of the primary causes of secondary renal dysfunction. It was reported that the morbidity of CIN was 2%–30% after PCI [11]

Methods

Results

Conclusion