Hydration Based On Ventricular Pressure Is Effective In Reducing Kidney Damage In Patients Undergoing Cardiac Catheterization

Authors: Medical News Today

Main Category: Cardiovascular / Cardiology
Also Included In: Urology / Nephrology
Article Date: 26 Oct 2012 - 3:00 PDT

Current ratings for:
Hydration Based On Ventricular Pressure Is Effective In Reducing Kidney Damage In Patients Undergoing Cardiac Catheterization


Patient / Public:4 stars
Healthcare Prof:Hydration Based On Ventricular Pressure Is Effective In Reducing Kidney Damage In Patients Undergoing Cardiac Catheterization

4 (1 votes)


Results of the POSEIDON trial presented at TCT 2012

A hydration regimen tailored to the patient's fluid status was effective in reducing damage to kidneys in patients undergoing cardiac catheterization, according to a study presented at the 24th annual Transcatheter Cardiovascular Therapeutics (TCT) scientific symposium, sponsored by the Cardiovascular Research Foundation. TCT is the world's premier educational meeting specializing in interventional cardiovascular medicine.

Contrast-induced acute kidney injury (CI-AKI), or contrast-induced nephropathy, refers to kidney damage that may occur due to the use of contrast dye that is necessary for visualization during catheterization and other procedures. Hydration remains the cornerstone for the prevention of kidney damage. However, there are no well-defined practical hydration protocols available for the prevention of CI-AKI. The Prevention of Contrast Renal Injury with Different Hydration Strategies (POSEIDON) trial investigated a novel sliding scale hydration protocol based upon routine invasively obtained left ventricular end-diastolic pressure measurements (LVEDP) in patients undergoing cardiac catheterization.

Patients undergoing coronary angiography with stable renal insufficiency (an estimated GFR

Both groups received 0.9 percent saline at 3 mL/kg for at least one hour prior to cardiac catheterization. The LVEDP was measured in all patients at the start of the procedure and prior to contrast administration. In the LVEDP group, the fluid rate was adjusted according to the patients' LVEDP as follows: 5 mL/kg/hr for LVEDP 18 mmHg.

The standard hydration group was hydrated at 1.5 mL/kg/hr. The fluid rate was set at the start of the procedure (prior to contrast exposure), continued during the procedure, and for four hours post-procedure. The primary outcome, CI-AKI, was defined as a greater than 25 percent or greater than 0.5 mg/dl increase in serum creatinine - an indicator of kidney damage - up to four days post-procedure.

There were 396 patients randomized, 196 in the LVEDP group and 200 in the standard hydration group. Kidney damage was found in 6.7 percent of the LVEDP guided hydration group and in 16.3 percent of the standard hydration group (P = 0.005). There were no significant differences between groups for baseline renal function or LVEDP. The relative risk (95 percent confidence interval) for LVEDP-guided hydration versus standard hydration was 0.41 (0.22-0.79). The absolute risk difference was -9.5 percent in favor of LVEDP guided hydration; therefore, 11 patients would need to be treated to prevent one CI-AKI event.

"This is the first trial to test the hypothesis of a left ventricular end diastolic pressure-guided hydration strategy for prevention of contrast nephropathy. We found that this technique resulted in a significant 59 percent relative and 10 percent absolute reduction in contrast nephropathy," said lead researcher Somjot Brar, MD, MPH. Dr. Brar is an Interventional Cardiologist & Vascular Specialist at Kaiser Permanente in Los Angeles, CA and an Assistant Clinical Professor of Medicine at the University of California, Los Angeles.

"This is an easily implemented protocol that can be readily adapted in both inpatient and outpatient settings," Dr. Brar said.

Article adapted by Medical News Today from original press release. Click 'references' tab above for source.
Visit our cardiovascular / cardiology section for the latest news on this subject.
The trial was funded by Kaiser Permanente.
Cardiovascular Research Foundation
Please use one of the following formats to cite this article in your essay, paper or report:

MLA

n.p. "Hydration Based On Ventricular Pressure Is Effective In Reducing Kidney Damage In Patients Undergoing Cardiac Catheterization." Medical News Today. MediLexicon, Intl., 26 Oct. 2012. Web.
3 Nov. 2012. <http://www.medicalnewstoday.com/releases/252043.php>


APA

Please note: If no author information is provided, the source is cited instead.


Contact Our News Editors

For any corrections of factual information, or to contact the editors please use our feedback form.

Please send any medical news or health news press releases to:

Note: Any medical information published on this website is not intended as a substitute for informed medical advice and you should not take any action before consulting with a health care professional. For more information, please read our terms and conditions.

Read more http://www.medicalnewstoday.com/releases/252043.php

PUA Social Network

Twitter Facebook

Contact us

The Philippine Urological Association,Inc
3rd floor. PCS Bldg., 992 EDSA, Quezon City,
Metro Manila, PHILIPPINES 1105
View Map

+632-9256740 
+632-4544439
+63917-5244456

eMail us