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Prevention of contrast media-induced renal dysfunction with prostaglandin E1: a randomized, double-blind, placebo-controlled study.

Publication ,  Journal Article
Sketch, MH; Whelton, A; Schollmayer, E; Koch, JA; Bernink, PJ; Woltering, F; Brinker, J; Prostaglandin E1 Study Group,
Published in: Am J Ther
2001

Preexisting renal impairment is an all-encompassing risk factor for radiocontrast-associated nephrotoxicity. Renal impairment appears to be associated with the inadequate production of renal prostaglandins at the critical time of radiocontrast administration and for a variable time period afterward. We prospectively studied 130 patients with chronic renal insufficiency (serum creatinine > or =1.5 mg/dL) who were undergoing radiocontrast administration. Using a double-blind, randomized, prospective technique, patients were assigned to either placebo or one of three prostaglandin E1 (PGE1) treatment groups (10, 20, or 40 ng/kg/min). Infusion was started 60 +/- 30 minutes before the administration of radiocontrast and was continued for a total of 6 hours. In the placebo group, radiocontrast administration resulted in a mean increase (+/- SD) in serum creatinine of 0.72 +/- 1.15 mg/dL at 48 hours. This increase was less in each of the PGE1 treatment groups after 48 hours, with a significant difference between placebo and the 20 ng/kg/min PGE1 group (P = 0.01). Using baseline adjusted means, analysis of covariance with baseline serum creatinine as the covariable demonstrated significant differences between the placebo and 20 ng/kg/min PGE1 group (P = 0.03) and between the placebo and 10 ng/kg/min PGE1 group P = 0.047). In a subgroup analysis of the diabetic patients, the increase in serum creatinine was less pronounced in the three PGE1 groups versus the placebo group, and the 20 ng/kg/min PGE1 group had the most favorable outcome. The parenteral administration of PGE1 immediately before radiocontrast exposure and continued for a period of 5 to 5.5 hours significantly reduced the elevation of serum creatinine poststudy. The most effective of the three PGE1 dosing regimens was 20 ng/kg/min.

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Published In

Am J Ther

DOI

ISSN

1075-2765

Publication Date

2001

Volume

8

Issue

3

Start / End Page

155 / 162

Location

United States

Related Subject Headings

  • Prospective Studies
  • Pilot Projects
  • Middle Aged
  • Male
  • Kidney Failure, Chronic
  • Kidney
  • Humans
  • Female
  • Double-Blind Method
  • Creatinine
 

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Sketch, M. H., Whelton, A., Schollmayer, E., Koch, J. A., Bernink, P. J., Woltering, F., … Prostaglandin E1 Study Group, . (2001). Prevention of contrast media-induced renal dysfunction with prostaglandin E1: a randomized, double-blind, placebo-controlled study. Am J Ther, 8(3), 155–162. https://doi.org/10.1097/00045391-200105000-00004
Sketch, M. H., A. Whelton, E. Schollmayer, J. A. Koch, P. J. Bernink, F. Woltering, J. Brinker, and J. Prostaglandin E1 Study Group. “Prevention of contrast media-induced renal dysfunction with prostaglandin E1: a randomized, double-blind, placebo-controlled study.Am J Ther 8, no. 3 (2001): 155–62. https://doi.org/10.1097/00045391-200105000-00004.
Sketch MH, Whelton A, Schollmayer E, Koch JA, Bernink PJ, Woltering F, et al. Prevention of contrast media-induced renal dysfunction with prostaglandin E1: a randomized, double-blind, placebo-controlled study. Am J Ther. 2001;8(3):155–62.
Sketch, M. H., et al. “Prevention of contrast media-induced renal dysfunction with prostaglandin E1: a randomized, double-blind, placebo-controlled study.Am J Ther, vol. 8, no. 3, 2001, pp. 155–62. Pubmed, doi:10.1097/00045391-200105000-00004.
Sketch MH, Whelton A, Schollmayer E, Koch JA, Bernink PJ, Woltering F, Brinker J, Prostaglandin E1 Study Group. Prevention of contrast media-induced renal dysfunction with prostaglandin E1: a randomized, double-blind, placebo-controlled study. Am J Ther. 2001;8(3):155–162.

Published In

Am J Ther

DOI

ISSN

1075-2765

Publication Date

2001

Volume

8

Issue

3

Start / End Page

155 / 162

Location

United States

Related Subject Headings

  • Prospective Studies
  • Pilot Projects
  • Middle Aged
  • Male
  • Kidney Failure, Chronic
  • Kidney
  • Humans
  • Female
  • Double-Blind Method
  • Creatinine