[Monocentric experience of the RenalGuard® system to limit post-contrast acute kidney injury in patients at high-risk undergoing interventional coronary procedures].
Expérience monocentrique du système RenalGuard® pour limiter l'insuffisance rénale aiguë post-contraste après une procédure coronaire interventionnelle chez des patients à haut risque.
Acute kidney injury post-contrast
Chronic kidney disease
Contrast media
Insuffisance rénale chronique
Percutaneous coronary interventions
RenalGuard® System
insuffisance rénale aiguë post-contraste
interventions coronaires percutanées
produit de contraste iodé
système RenalGuard®
Journal
Annales de cardiologie et d'angeiologie
ISSN: 1768-3181
Titre abrégé: Ann Cardiol Angeiol (Paris)
Pays: France
ID NLM: 0142167
Informations de publication
Date de publication:
Nov 2022
Nov 2022
Historique:
received:
25
08
2022
accepted:
25
08
2022
pubmed:
18
9
2022
medline:
29
11
2022
entrez:
17
9
2022
Statut:
ppublish
Résumé
Despite an often favorable risk/benefit ratio, patients with severe chronic kidney disease are sometimes declined for interventional coronary procedures, due to the risk of acute kidney injury post-contrast (AKI-PC). A large preventive supply of intravenous fluid may be problematic in this population. The RenalGuard® system allows hyperhydration by maintaining a stable volemia through an enhanced diuresis. This work reports the evaluation of the RenalGuard® system in 25 consecutive patients with chronic kidney disease (glomerular filtration rate < 40 mL/min/1.73 m²) requiring an interventional coronary procedure (coronary angiography and/or percutaneous coronary intervention) and at high risk of IRA-PC. An increase in serum creatinine ≥ 26.5 µmol/L at 48-72 hours (AKI-PC definition) was observed in 4 patients (16%). The mean glomerular filtration rate was 26 ± 8 mL/min/1.73 m² at 48-72 hours versus 25 ± 8 mL/min/1.73 m² at baseline. No patient presented with an increase in serum creatinine ≥ 1.5 from baseline, stage 2 or 3 AKI, or acute pulmonary edema. No renal replacement therapy was necessary. One death unrelated to AKI-PC occurred during hospital stay. This single-center observational study suggests that the RenalGuard® system, allowing diuresis-adjusted hyperhydration, is safe and useful for patients at high risk of AKI-PC after an interventional coronary procedure.
Sections du résumé
BACKGROUND
BACKGROUND
Despite an often favorable risk/benefit ratio, patients with severe chronic kidney disease are sometimes declined for interventional coronary procedures, due to the risk of acute kidney injury post-contrast (AKI-PC). A large preventive supply of intravenous fluid may be problematic in this population. The RenalGuard® system allows hyperhydration by maintaining a stable volemia through an enhanced diuresis.
METHODS AND RESULTS
RESULTS
This work reports the evaluation of the RenalGuard® system in 25 consecutive patients with chronic kidney disease (glomerular filtration rate < 40 mL/min/1.73 m²) requiring an interventional coronary procedure (coronary angiography and/or percutaneous coronary intervention) and at high risk of IRA-PC. An increase in serum creatinine ≥ 26.5 µmol/L at 48-72 hours (AKI-PC definition) was observed in 4 patients (16%). The mean glomerular filtration rate was 26 ± 8 mL/min/1.73 m² at 48-72 hours versus 25 ± 8 mL/min/1.73 m² at baseline. No patient presented with an increase in serum creatinine ≥ 1.5 from baseline, stage 2 or 3 AKI, or acute pulmonary edema. No renal replacement therapy was necessary. One death unrelated to AKI-PC occurred during hospital stay.
CONCLUSIONS
CONCLUSIONS
This single-center observational study suggests that the RenalGuard® system, allowing diuresis-adjusted hyperhydration, is safe and useful for patients at high risk of AKI-PC after an interventional coronary procedure.
Identifiants
pubmed: 36115720
pii: S0003-3928(22)00127-5
doi: 10.1016/j.ancard.2022.08.011
pii:
doi:
Substances chimiques
Creatinine
AYI8EX34EU
Contrast Media
0
Types de publication
Observational Study
English Abstract
Journal Article
Langues
fre
Sous-ensembles de citation
IM
Pagination
283-289Informations de copyright
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