College of Cardiology 60th Annual Scientific Sessions
NEW ORLEANS Compared with conventional hydration
treatment, use of the RenalGuard System in patients with chronic kidney disease
improved the safety of image-guided cardiology procedures, which led to fewer
cases of contrast-induced acute kidney injury, according to findings presented
This trial demonstrates that the RenalGuard
System [PLC Medical Systems] is very good device to prevent contrast-induced
acute kidney injury in high-risk patients, said Carlo Briguori,
MD, PhD, lead study author and director, Laboratory of
Interventional Cardiology, Clinica Mediterranea, Naples, in a press conference.
The Italy-based study was conducted at four
interventional cardiology centers and included 292 patients with
chronic kidney disease. Patients were scheduled for coronary
and/or peripheral angiography and/or angioplasty between January 2009 and
December 2010. They were randomized to receive either conventional hydration
that included a combination of N-acetylcysteine (NAC) and sodium bicarbonate
solution or hydration with normal saline plus NAC and low-dose furosemide
controlled by the RenalGuard System. Biomarkers such as serum creatinine (sCr)
and cystatin C were assessed the day before and up to 1 week following the
The researchers reported that the primary endpoint of
the development of contrast-induced acute kidney injury CI-AKI (sCr increase
≥0.3 mg/dL at 48 hours) was nearly two times higher in the conventional
treatment group (20.5% vs. 11%; P=.025). Non-statistically significant
more patients experienced stage 2 or 3 damage in the conventional arm (23% vs.
6%; P=.14) as well.
Additional analysis revealed that a lower rate of
in-hospital renal failure requiring
dialysis occurred in the RenalGuard System group (0.7% vs.
4.1%; P=0.056), although rates of in-hospital stay and major adverse
events were similar between groups.
For Briguori, the rate of dialysis was the most
important clinical finding, because it shows the possibility to prevent this
very improbable complication. by Brian Ellis
Disclosure: Dr. Briguori reports no relevant
For more information:
- Briguori C. LBCT III, Session 3014. Presented at: ACC 60th Annual
Scientific Sessions; April 2-5, 2011; New Orleans.