EECP Effectively Clears Contrast Agent, and Reduces the Risk of Contrast-Induced Acute Kidney Injury 體外反搏治療有效增加碘造影劑的清除率,從而減低造影劑誘發的 急性腎損傷

Source From 資料來源 : https://www.sciencedirect.com/science/article/abs/pii/S155171442100389X?via%3Dihub

EECP Effectively Clears Contrast Agent, and Reduces the Risk of Contrast-Induced Acute Kidney Injury

BACKGROUND:

Contrast-induced acute kidney injury (CI-AKI) is a common complication after exposure to contrast media. Renal ischaemia occurs in the initial stage of CI-AKI, however, there are very few effective measures to improve renal perfusion.

METHODS:

A total of 114 patients with an estimated glomerular filtration rate (eGFR) of 60-89 ml/min/1.73m2 were randomly assigned to two groups: enhanced external counterpulsation (EECP) group (N = 57) and control group (N = 57). Two hours after contrast exposure, EECP group received EECP treatment for 1 h while no intervention was performed control group. The primary outcome was the incidence of serum cystatin C concentration to 10% above the baseline concentration at 24 h after contrast administration. The secondary outcomes were the incidence of CI-AKI (defined as an increase in serum creatinine concentration to ≥0.5 mg/dl or by 25% compare to the baseline after contrast exposure), contrast clearance and adverse clinical events.

RESULTS:

The primary outcome was observed in 26 patients (6 EECP and 20 control; 11% vs. 35%; P = 0.002). CI-AKI occurred in four patients (0 EECP and 4 control; 0% vs. 7%; P = 0.042). The clearance rate of iopromide in the initial 3 h was significantly different between EECP and control group (59.92 ± 8.84 vs 46.80 ± 9.26 ml/min/1.73 m2; P < 0.001). No adverse clinical events were observed in this study.

CONCLUSIONS:

This study demonstrates that EECP increases the contrast clearance and may have an effect in reducing the risk of CI-AKI. The study has been registered in Chinese Clinical Trial Registry (ChiCTR 2,000,039,190).

「增強體外反搏:減輕造影劑引起的 急性腎損傷 的新方法」

背景

接觸造影介質後引起的對比劑誘導 急性腎損傷 (CI-AKI)是一種常見併發症。在CI-AKI的初期階段,腎缺血是一種常見情況,但是目前很少有有效的措施來改善腎臟灌注。

方法

共納入114名估計腎小球濾過率(eGFR)為60-89 ml/min/1.73m2的患者,隨機分為兩組:體外反搏治療(EECP)組和對照組。造影介質注射後2小時,EECP組接受1小時的EECP治療,而對照組不進行干預。主要結果是造影後24小時血清半胱氨酸蛋白C濃度增加到基線濃度的10%以上的發生率。次要結果包括CI-AKI的發生率、對比劑清除率和不良臨床事件。

結果

在26名患者中觀察到主要結果(EECP組6例,對照組20例;11%對比35%)。CI-AKI在4名患者中發生(EECP組0例,對照組4例;0%對比7%)。EECP組和對照組初始3小時的碘普羅胺清除率差異顯著(59.92 ± 8.84對比46.80 ± 9.26 ml/min/1.73 m2)。本研究未觀察到不良臨床事件。

結論

本研究表明,EECP可以增加對比劑的清除率,並可能在降低CI-AKI風險方面發揮作用。

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