OUTCOMES OF PRE AND POST INTRAVENOUS HYDRATION FOR INTRAVENOUS PYELOGRAPHY IN HIGH RISK PATIENTS WITH CONTRAST-INDUCED ACUTE KIDNEY INJURY

Abstract

ABSTRACT

BACKGROUND Intravenous pyelography(IVP) are being used with increasing frequency at Fang hospital. Patients with renal impairment had higher risk of contrast-induced acute kidney injury (CI-AKI). Therefore, preprocedural and postprocedural intravenous hydration was suggested. 

OBJECTIVE To study outcomes of intravenous hydration for prevention of CI-AKI in high risk patients  METHOD This research wasa retrospective studyat Fang hospital. Between June 2015 and December 2017, data were collected from hospitalized patients whom were carried out intravenous pyelography (IVP) and their eGFRwere 30-60 ml/min/1.73 m².They also recieved isotonic sodium chloride hydration about 0.5-1 cc/kg/hour at least 12 hours before and after the procedure of intravenous pyelography.Serum creatinine (sCr) and estimated glomerular filtration rate (eGFR) were investigated after completing the procedure. Data was analyzed using descriptive statistics and inferential statistics (paired t-test)

RESULTS A total of 68 patients were in this study and 85.3% yielded positive result of IVP. Meansof sCr and eGFRof pre- procedural hydration were 1.42 and 48.39respectively. Meansof sCr and eGFR post- procedural hydration were 1.19 and 61.94respectively. There were statistically significant differences both parameters between pre- and post-procedural hydration. (p< 0.001)

CONCLUSION AND DISCUSSION It seemed that isotonic intravenous hydration could reduce the incidence of CI-AKI in patients with high risk. However, several factors, such as diabetes mellitus, nephrotoxic drug, dehydration and prior renal surgery, could increase the risks. Thus, a proper investigation should be changed to ultrasonogram or non-contrast CT KUB for patients with multiple risk factors.