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Zhou J, Jiang S, Li Z, Li W. Beraprost Sodium Delays the Decline of Glomerular Filtration Rate in Patients with Diabetic Nephropathy: A Retrospective Study. Diabetes Ther 2023; 14:497-506. [PMID: 36602671 PMCID: PMC9981824 DOI: 10.1007/s13300-022-01361-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Accepted: 12/19/2022] [Indexed: 01/06/2023] Open
Abstract
INTRODUCTION To investigate the reno-protective effect of beraprost sodium (BPS) in patients with diabetic nephropathy (DN). METHODS We retrospectively analyzed patients with DN hospitalized in China-Japan Friendship Hospital from January 2015 to December 2021 who received combination of conventional treatment and BPS (120 ug/day) therapy. We selected patients with DN matched in age and estimated glomerular filtration rate (eGFR) as controls, who received only conventional therapy. Baseline information and clinical variables at each follow-up visit were collected from all patients. The changes of clinical variables were compared between the two groups before and after treatment. RESULTS A total of 50 patients with DN met the inclusion and exclusion criteria, with 25 patients in each group. The baseline characteristics of the two groups have no significant difference (p > 0.05). Serum albumin levels after treatment were improved in both groups, but the improvement was statistically significant only in BPS group (35.5-39.8 g/l, p < 0.001). The eGFR worsened significantly in both groups (p = 0.009 and p = 0.001). However, the decline of eGFR was less in BPS group than that in control group (- 9.8 vs. - 16.7 ml/min/1.73 m2, p = 0.037). In the subgroup analysis, 30 patients received 3-12 months treatment and 20 patients received more than 12 months treatment. During the 3-12 months treatment period, serum creatinine and eGFR in the control group were significantly worsened compared with those before treatment (p = 0.019 and p = 0.03), but in the BPS group they were relatively stable (p > 0.05). After more than 12 months treatment, although the serum creatinine and eGFR were significantly worsened in both groups (p < 0.05), the decline of eGFR was less in BPS group than that in control group (- 10.1 vs. - 25.9 ml/min/1.73 m2, p = 0.045). CONCLUSIONS Combination of conventional treatment and BPS therapy delays the decline of eGFR in patients with DN in the long term.
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Affiliation(s)
- Jingjing Zhou
- Department of Nephrology, China-Japan Friendship Hospital, Capital Medical University, No. 2 East Yinghuayuan Street, Chaoyang District, Beijing, 100029, China
- Department of Nephrology, Beijing Luhe Hospital, Capital Medical University, Beijing, 101100, China
| | - Shimin Jiang
- Department of Nephrology, China-Japan Friendship Hospital, Capital Medical University, No. 2 East Yinghuayuan Street, Chaoyang District, Beijing, 100029, China.
| | - Zhongxin Li
- Department of Nephrology, Beijing Luhe Hospital, Capital Medical University, Beijing, 101100, China
| | - Wenge Li
- Department of Nephrology, China-Japan Friendship Hospital, Capital Medical University, No. 2 East Yinghuayuan Street, Chaoyang District, Beijing, 100029, China.
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Feng YL, Yang Y, Chen H. Small molecules as a source for acute kidney injury therapy. Pharmacol Ther 2022; 237:108169. [DOI: 10.1016/j.pharmthera.2022.108169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 02/28/2022] [Accepted: 03/07/2022] [Indexed: 10/18/2022]
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Walker H, Guthrie GD, Lambourg E, Traill P, Zealley I, Plumb A, Bell S. Systematic review and meta-analysis of prophylaxis use with intravenous contrast exposure to prevent contrast-induced nephropathy. Eur J Radiol 2022; 153:110368. [DOI: 10.1016/j.ejrad.2022.110368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 05/05/2022] [Accepted: 05/18/2022] [Indexed: 11/03/2022]
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Xu H, Wang H, Zhang C, Xiao J, Hua N, Tang X, Xie J, Zhang Z. Efficacy of Alprostadil in Preventing Contrast-Induced Nephropathy: A Systematic Review and Meta-Analysis. Angiology 2021; 72:878-888. [PMID: 33853365 DOI: 10.1177/00033197211004412] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This study aimed to determine the efficacy of alprostadil in preventing contrast-induced nephropathy (CIN). Eligible studies were searched using the keywords through the databases of PubMed, Cochrane, Embase, China Biological Medicine Database, China National Knowledge Infrastructure, and Vanfun. Quality evaluation of the included studies was conducted according to international evidence evaluation and recommended Grades of Recommendations Assessment, Development, and Evaluation standards. We included 29 studies with 5623 patients. Compared with hydration, 10 µg/d alprostadil or 20 µg/d alprostadil plus hydration significantly decreased the incidence of CIN. Compared with hydration, alprostadil plus hydration significantly reduced serum creatinine and blood urea nitrogen at 24, 48, and 72 hours and 7 days after coronary angiography (CAG). Alprostadil (20 µg/d) plus hydration significantly decreased serum cystatin versus hydration at 24, 48, and 72 hours after CAG. Compared with hydration, alprostadil plus hydration significantly increased glomerular filtration rate at 24 and 72 hours after CAG. Alprostadil plus hydration significantly decreased neutrophil gelatinase-associated lipocalin levels compared to hydration at 24, 48, and 72 hours after CAG. Alprostadil plus hydration significantly decreased urine macroglobulin versus hydration at 24 and 48 hours after CAG.
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Affiliation(s)
- Hongling Xu
- Department of Cardiology, The 8th Medical Center of Chinese PLA General Hospital, Beijing, People's Republic of China.,These authors contributed equally to this paper
| | - Hongye Wang
- Department of Cardiology, The 8th Medical Center of Chinese PLA General Hospital, Beijing, People's Republic of China.,These authors contributed equally to this paper
| | - Chuang Zhang
- Department of Cardiology, The 8th Medical Center of Chinese PLA General Hospital, Beijing, People's Republic of China.,These authors contributed equally to this paper
| | - Jun Xiao
- Department of Geriatric Medicine, The 8th Medical Center of Chinese PLA General Hospital, Beijing, People's Republic of China
| | - Ning Hua
- Department of Cardiology, The 8th Medical Center of Chinese PLA General Hospital, Beijing, People's Republic of China
| | - Xuezheng Tang
- Department of Cardiology, The 8th Medical Center of Chinese PLA General Hospital, Beijing, People's Republic of China
| | - Jiaqi Xie
- Department of Cardiology, The 8th Medical Center of Chinese PLA General Hospital, Beijing, People's Republic of China
| | - Zhengbin Zhang
- Department of Cardiology, The 8th Medical Center of Chinese PLA General Hospital, Beijing, People's Republic of China
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Zhang L, Li P, Zhang BL, Yu ML, Xu RL, Wu H, Chen SP. Dysregulation of HULC promotes contrast-induced nephropathy (CIN) via regulating signaling pathway of miRNA-512 and prostaglandin E1 (PGE 1). Sci Rep 2020; 10:11691. [PMID: 32678165 PMCID: PMC7366906 DOI: 10.1038/s41598-020-68634-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Accepted: 06/04/2020] [Indexed: 01/11/2023] Open
Abstract
It has been shown that contrast-induced nephropathy (CIN) can be attenuated by the administration of PGE1. As an enzyme responsible for the production of PGE1, PTGS1 was confirmed in this study as a miR-512 target. Meanwhile, HULC has been identified as a competing endogenous RNA of miR-512. Therefore, in this study, we tested the diagnostic value of HULC and miR-512 in subjects with or without CIN. In addition, we evaluated the regulatory relationship among HULC, miR-512, PTGS1 and PGE1 in vitro. We enrolled 320 patients with coronary heart disease and divided them into a CIN group and a non-CIN group. Subsequently, we detected the differential expression of miR-512, HULC and PGE1 in the two groups. We also used a dual luciferase reporter assay to evaluate the regulatory relationship among HULC, miR-512, PTGS1 and PGE1 in THP-1 cells. In patients with CIN, the expression levels of HULC and PGE1 were lower, but the expression level of miR-512 was higher. MiR-512 could directly bind to and negatively regulate the expression of PTGS1 and HULC. The expression of HULC was positively correlated with the expression of PTGS1 and PGE1, while negatively correlated with the expression of miR-512. The findings of this study demonstrated that deregulation of lncRNA-HULC/miR-512/PTGS1/PGE1 might be involved in the pathogenesis of CIN.
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Affiliation(s)
- Liang Zhang
- Department of Cardiology, The First Affiliated Hospital of the Second Military Medical University, No. 168 Changhai Road, Yangpu District, Shanghai, People's Republic of China
| | - Pan Li
- Department of Cardiology, The First Affiliated Hospital of the Second Military Medical University, No. 168 Changhai Road, Yangpu District, Shanghai, People's Republic of China
| | - Bi-Li Zhang
- Department of Cardiology, The First Affiliated Hospital of the Second Military Medical University, No. 168 Changhai Road, Yangpu District, Shanghai, People's Republic of China.
| | - Man-Li Yu
- Department of Cardiology, The First Affiliated Hospital of the Second Military Medical University, No. 168 Changhai Road, Yangpu District, Shanghai, People's Republic of China
| | - Rong-Liang Xu
- Department of Cardiology, The First Affiliated Hospital of the Second Military Medical University, No. 168 Changhai Road, Yangpu District, Shanghai, People's Republic of China
| | - Hong Wu
- Department of Cardiology, The First Affiliated Hospital of the Second Military Medical University, No. 168 Changhai Road, Yangpu District, Shanghai, People's Republic of China
| | - Shao-Ping Chen
- Department of Cardiology, The First Affiliated Hospital of the Second Military Medical University, No. 168 Changhai Road, Yangpu District, Shanghai, People's Republic of China
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Asmamaw T, Genet S, Menon M, Tarekegn G, Chekol E, Geto Z, Lejisa T, Habtu W, Getahun T, Tolcha Y. Early Detection of Renal Impairment Among Patients with Type 2 Diabetes Mellitus Through Evaluation of Serum Cystatin C in Comparison with Serum Creatinine Levels: A Cross-Sectional Study. Diabetes Metab Syndr Obes 2020; 13:4727-4735. [PMID: 33299336 PMCID: PMC7721116 DOI: 10.2147/dmso.s279949] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Accepted: 11/12/2020] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND The proportion of patients with end-stage renal disease caused by diabetes has progressively increased during the last few decades. Serum creatinine level is the most commonly used biochemical parameter to estimate GFR in routine practice. However, 50% of GFR can be lost before significant elevation of serum creatinine. Cystatin C is found to be a new promising marker for early detection of renal diseases. OBJECTIVE OF THE STUDY The aim of this study was to determine the value of serum cystatin C and serum creatinine levels for early detection of renal disease in patients with type 2 diabetes mellitus. METHODOLOGY A hospital-based comparative cross-sectional study was conducted with a sample size of 120. For early detection of renal disease in patients with type 2 diabetes mellitus, serum creatinine and cystatin C levels were measured and compared. RESULT AND DISCUSSION Serum creatinine and cystatin C levels were significantly increased in patients with type 2 diabetes mellitus compared to healthy controls. The mean±SD value of serum creatinine was found to be 0.87±0.44 mg/dL in patients and 0.63±0.27 mg/dL in control. Serum cystatin C level was also found to be significantly (P=0.0001) higher in patients (0.92±0.38 mg/L) compared to controls (0.52±0.20 mg/L). The mean±SD of eGFR in three equations (Creatinine Equation, Cystatin C Equation, and Creatinine-Cystatin C Equation) were 105.7±27.5 mL/min/m2, 90.4±28.2 mL/min/m2, and 100±29.5 mL/min/m2, respectively. CONCLUSION Cystatin C-based GFR estimation equations detect renal impairment in patients with type 2 diabetes mellitus earlier than creatinine-based GFR estimation equations.
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Affiliation(s)
- Tadesse Asmamaw
- Department of Biochemistry, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
- Correspondence: Tadesse Asmamaw Email
| | - Solomon Genet
- Department of Biochemistry, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Menakath Menon
- Department of Biochemistry, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Getahun Tarekegn
- Department of Internal Medicine, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Endeshaw Chekol
- Department of Biochemistry, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Zeleke Geto
- National Reference Laboratory for Clinical Chemistry, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Tadesse Lejisa
- National Reference Laboratory for Clinical Chemistry, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Wossene Habtu
- National Reference Laboratory for Clinical Chemistry, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Tigist Getahun
- National Reference Laboratory for Clinical Chemistry, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Yosef Tolcha
- National Reference Laboratory for Clinical Chemistry, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
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Xie J, Jiang M, Lin Y, Deng H, Li L. Effect of Alprostadil on the Prevention of Contrast-Induced Nephropathy: A Meta-Analysis of 36 Randomized Controlled Trials. Angiology 2019; 70:594-612. [PMID: 30669852 DOI: 10.1177/0003319719825597] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Contrast-induced nephropathy (CIN) is the third leading cause of acquired acute renal injury in hospitalized patients. Alprostadil plays a role in the maintenance and redistribution of intrarenal blood flow and the excretion of electrolytes and water. However, the effectiveness of alprostadil in preventing CIN remains controversial. Thirty-six articles with a total of 5495 patients were included in this study. Both groups (experimental group and control group) received standard hydration therapy. In the experimental group, patients received different doses of alprostadil. Serum creatinine (SCr), blood urea nitrogen (BUN), estimated glomerular filtration rate (eGFR), cystatin C, creatinine clearance rate (CCr), and β2-microglobulin (β2-MG) were measured at 24, 48, and 72 hours after contrast media injection. The incidence of CIN in the experimental group was significantly lower than that in the control group (6.56% vs 16.74%). The level of SCr, cystatin C, BUN, and β2-MG in the experimental group was lower than those in the control group; CCr and eGFR in the experimental group were higher than those in the control group. This study demonstrated that alprostadil may reduce the incidence of CIN in patients undergoing coronary angiogram and/or percutaneous coronary intervention.
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Affiliation(s)
- Jian Xie
- Department of Cardiology, The First Affiliated Hospital of Guangxi Medical University, Guangxi Cardiovascular Institute, Nanning, Guangxi, China
| | | | - Yunni Lin
- Guangxi Medical University, Nanning, Guangxi, China
| | - Huachu Deng
- Guangxi Medical University, Nanning, Guangxi, China
| | - Lang Li
- Department of Cardiology, The First Affiliated Hospital of Guangxi Medical University, Guangxi Cardiovascular Institute, Nanning, Guangxi, China
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Ahmed K, McVeigh T, Cerneviciute R, Mohamed S, Tubassam M, Karim M, Walsh S. Effectiveness of contrast-associated acute kidney injury prevention methods; a systematic review and network meta-analysis. BMC Nephrol 2018; 19:323. [PMID: 30424723 PMCID: PMC6234687 DOI: 10.1186/s12882-018-1113-0] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2017] [Accepted: 10/22/2018] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Different methods to prevent contrast-associated acute kidney injury (CA-AKI) have been proposed in recent years. We performed a mixed treatment comparison to evaluate and rank suggested interventions. METHODS A comprehensive Systematic review and a Bayesian network meta-analysis of randomised controlled trials was completed. Results were tabulated and graphically represented using a network diagram; forest plots and league tables were shown to rank treatments by the surface under the cumulative ranking curve (SUCRA). A stacked bar chart rankogram was generated. We performed main analysis with 200 RCTs and three analyses according to contrast media and high or normal baseline renal profile that includes 173, 112 & 60 RCTs respectively. RESULTS We have included 200 trials with 42,273 patients and 44 interventions. The primary outcome was CI-AKI, defined as ≥25% relative increase or ≥ 0.5 mg/dl increase from baseline creatinine one to 5 days post contrast exposure. The top ranked interventions through different analyses were Allopurinol, Prostaglandin E1 (PGE1) & Oxygen (0.9647, 0.7809 & 0.7527 in the main analysis). Comparatively, reference treatment intravenous hydration was ranked lower but better than Placebo (0.3124 VS 0.2694 in the main analysis). CONCLUSION Multiple CA-AKI preventive interventions have been tested in RCTs. This network evaluates data for all the explored options. The results suggest that some options (particularly allopurinol, PGE1 & Oxygen) deserve further evaluation in a larger well-designed RCTs.
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Affiliation(s)
- Khalid Ahmed
- Lambe Institute for Translational Research, Discipline of Surgery National University of Ireland, Galway, Republic of Ireland. .,Department of Vascular surgery, Galway University Hospital, Galway, Republic of Ireland.
| | - Terri McVeigh
- Lambe Institute for Translational Research, Discipline of Surgery National University of Ireland, Galway, Republic of Ireland
| | - Raminta Cerneviciute
- Lambe Institute for Translational Research, Discipline of Surgery National University of Ireland, Galway, Republic of Ireland
| | - Sara Mohamed
- Lambe Institute for Translational Research, Discipline of Surgery National University of Ireland, Galway, Republic of Ireland
| | - Mohammad Tubassam
- Department of Vascular surgery, Galway University Hospital, Galway, Republic of Ireland
| | - Mohammad Karim
- School of Population and Public Health, University of British Columbia, Scientist / Biostatistician, Centre for Health Evaluation and Outcome Sciences (CHEOS), St. Paul's Hospital, Vancouver, Canada
| | - Stewart Walsh
- Lambe Institute for Translational Research, Discipline of Surgery National University of Ireland, Galway, Republic of Ireland.,Department of Vascular surgery, Galway University Hospital, Galway, Republic of Ireland.,HRB Clinical Research Facility Galway, Galway, Republic of Ireland
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Geng N, Zou D, Chen Y, Ren L, Xu L, Pang W, Sun Y. Prostaglandin E1 administration for prevention of contrast-induced acute kidney injury: A systematic review and meta-analysis of randomized controlled trials. Medicine (Baltimore) 2018; 97:e11416. [PMID: 30024512 PMCID: PMC6086538 DOI: 10.1097/md.0000000000011416] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND PGE1 has been studied for prevention of CI-AKI in several RCTs and significant heterogeneous results exist. METHODS We searched PubMed, EMBase, and Cochrane Central Register of Controlled Trials up to December 26, 2017 for RCTs comparing PGE1 with placebo or other active medications for the prevention of CI-AKI in patients. Odds ratio and 95% confidence interval (CI) were used for pooling dichotomous data, while mean difference and 95% confidence interval for pooling continuous data. RESULTS Seven RCTs involving 1760 patients were included in this meta-analysis. All these 7 trials reported the incidence of CI-AKI and compared with placebo or other treatment options, PGE1 was associated with a reduced risk of CI-AKI (OR: 0.38, 95% CI: 0.28-0.53; P < .001) and only a trend for lower post procedure serum creatinine (Scr) levels compared with control groups at 48 hours (MD: -0.03 mg/dL, 95% CI: -0.08 to 0.02 mg/dL; P = .25; 6 trials combined). But the postprocedure Scr levels were significantly reduced in PGE1 groups compared with control groups at 72 hours (MD: -0.07 mg/dL, 95% CI: -0.11 to -0.04 mg/dL; P < .001; 4 trials combined). We also meta-analyzed the postprocedure cystatin C (CysC) at 24 and 48 hours with 2 trials. There were lower postprocedure CysC levels in PGE1 groups than those in control groups (MD: -0.18 mg/L, 95% CI: -0.33 to -0.03 mg/L; P = .02 at 24 hours and MD: -0.14 mg/L, 95% CI: -0.23 to -0.06 mg/L; P = .001 at 48 hours). CONCLUSIONS PGE1 provides effective nephroprotection against CI-AKI and may act as a part of effective prophylactic pharmacological regimens.
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Affiliation(s)
- Ning Geng
- Department of Cardiology, Shengjing Hospital of China Medical University
| | - Deling Zou
- Department of Cardiology, Shengjing Hospital of China Medical University
| | - Yanli Chen
- Department of Cardiology, the First Affiliated Hospital of China Medical University
| | - Li Ren
- Department of Cardiology, Shengjing Hospital of China Medical University
| | - Lisheng Xu
- Sino-Dutch Biomedical and Information Engineering School, Northeastern University, Shenyang City, Liaoning Province, China
| | - Wenyue Pang
- Department of Cardiology, Shengjing Hospital of China Medical University
| | - Yingxian Sun
- Department of Cardiology, the First Affiliated Hospital of China Medical University
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van der Molen AJ, Reimer P, Dekkers IA, Bongartz G, Bellin MF, Bertolotto M, Clement O, Heinz-Peer G, Stacul F, Webb JAW, Thomsen HS. Post-contrast acute kidney injury. Part 2: risk stratification, role of hydration and other prophylactic measures, patients taking metformin and chronic dialysis patients : Recommendations for updated ESUR Contrast Medium Safety Committee guidelines. Eur Radiol 2018; 28:2856-2869. [PMID: 29417249 PMCID: PMC5986837 DOI: 10.1007/s00330-017-5247-4] [Citation(s) in RCA: 159] [Impact Index Per Article: 26.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2017] [Revised: 11/22/2017] [Accepted: 12/05/2017] [Indexed: 02/07/2023]
Abstract
OBJECTIVES The Contrast Media Safety Committee (CMSC) of the European Society of Urogenital Radiology (ESUR) has updated its 2011 guidelines on the prevention of post-contrast acute kidney injury (PC-AKI). The results of the literature review and the recommendations based on it, which were used to prepare the new guidelines, are presented in two papers. AREAS COVERED IN PART 2: Topics reviewed include stratification of PC-AKI risk, the need to withdraw nephrotoxic medication, PC-AKI prophylaxis with hydration or drugs, the use of metformin in diabetic patients receiving contrast medium and the need to alter dialysis schedules in patients receiving contrast medium. KEY POINTS • In CKD, hydration reduces the PC-AKI risk • Intravenous normal saline and intravenous sodium bicarbonate provide equally effective prophylaxis • No drugs have been consistently shown to reduce the risk of PC-AKI • Stop metformin from the time of contrast medium administration if eGFR < 30 ml/min/1.73 m 2 • Dialysis schedules need not change when intravascular contrast medium is given.
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Affiliation(s)
- Aart J van der Molen
- Department of Radiology, C2-S, Leiden University Medical Center, Albinusdreef 2, NL-2333 ZA, Leiden, The Netherlands
| | - Peter Reimer
- Institute for Diagnostic and Interventional Radiology Klinikum Karlsruhe, Moltkestraße 90, D-76133, Karlsruhe, Germany
| | - Ilona A Dekkers
- Department of Radiology, C2-S, Leiden University Medical Center, Albinusdreef 2, NL-2333 ZA, Leiden, The Netherlands
| | - Georg Bongartz
- Department of Diagnostic Radiology, University Hospitals of Basel, Petersgaben 4, CH-4033, Basel, Switzerland
| | - Marie-France Bellin
- Service Central de Radiologie Hôpital Paul Brousse 14, av. P.-V.-Couturier, F-94807, Villejuif, France
| | - Michele Bertolotto
- Department of Radiology, University of Trieste, Strada di Fiume 447, I-34149, Trieste, Italy
| | - Olivier Clement
- Department of Radiology, Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, 20 rue Leblanc, Paris Cedex 15, F-71015, Paris, France
| | - Gertraud Heinz-Peer
- Department of Radiology, Zentralinstitut für medizinische Radiologie, Diagnostik und Intervention, Landesklinikum St. Pölten, Propst Führer-Straße 4, AT-3100, St. Pölten, Austria
| | - Fulvio Stacul
- S.C. Radiologia Ospedale Maggiore, Piazza Ospitale 1, I-34129, Trieste, Italy
| | - Judith A W Webb
- Department of Radiology, St. Bartholomew's Hospital, University of London, West Smithfield, EC1A 7BE, London, UK
| | - Henrik S Thomsen
- Department of Diagnostic Radiology 54E2, Copenhagen University Hospital Herlev, Herlev Ringvej 75, DK-2730, Herlev, Denmark.
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Mou Y, Zhang Y, Guo C, Zhao J, Zhang Z, Zhou X, Dong J, Liao L. Integrated Treatment of Prostaglandin E1 and Angiotensin-Converting Enzyme Inhibitor in Diabetic Kidney Disease Rats: Possible Role of Antiapoptosis in Renal Tubular Epithelial Cells. DNA Cell Biol 2017; 37:133-141. [PMID: 29185789 DOI: 10.1089/dna.2017.3690] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
To investigate the therapeutic mechanisms underlying prostaglandin E1 (PGE1) and angiotensin-converting enzyme inhibitor (ACEI) on reducing urinary protein in diabetic kidney disease (DKD). DKD rats were established and randomly divided into four groups: PGE1 (10 μg/kg/day) (P group), ACEI (10 mg/kg/day) (A group), combination of PGE1 with ACEI treatment (P + A group), and saline treatment group (DKD group). Untreated rats were used as normal control (N group). Urinary albumin, endothelin-1 (ET-1), angiotensin II (AngII), TUNEL assay, Masson's trichrome staining, and immunohistochemistry staining for CD68 were evaluated in all groups. Ten days after treatment, urinary albumin was significantly decreased in the P and P + A groups (p < 0.01 vs. the DKD group). At the end of 8 weeks, the albumin was still significantly reduced in the P + A group (p < 0.05 vs. the A group). ET-1 and AngII were also significantly decreased in three treatment groups (p < 0.01 vs. the DKD group), especially in the P + A group. Few cells underwent apoptosis in glomerular regions in DKD rats, while amounts of apoptotic cells were seen in tubules regions. Further, apoptosis and the areas of fibrosis in tubulointerstitial were both decreased most in the P + A group compared with the DKD group. Apoptosis of renal tubular epithelial cells may participate in the development and progression of DKD in rats. Combination of PGE1 with AGEI remarkably protects renal function compared with PGE1 or ACEI monotherapy. The potential therapeutic mechanisms of PGE1 and AGEI might be via multiple targets and, at least in part, through inhibiting the apoptosis of renal tubular epithelial cells.
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Affiliation(s)
- Yaru Mou
- 1 Division of Cardiology, Department of Internal Medicine, Shandong Provincial Hospital Affiliated to Shandong University , Jinan, China
| | - Yaqin Zhang
- 2 Division of Endocrinology, Department of Internal Medicine, Shandong Provincial Qianfoshan Hospital, Shandong University , Jinan, China
| | - Congcong Guo
- 2 Division of Endocrinology, Department of Internal Medicine, Shandong Provincial Qianfoshan Hospital, Shandong University , Jinan, China .,3 First Clinical Medical College, Shandong University of Traditional Chinese Medicine , Jinan, China
| | - Junyu Zhao
- 2 Division of Endocrinology, Department of Internal Medicine, Shandong Provincial Qianfoshan Hospital, Shandong University , Jinan, China
| | - Zhongwen Zhang
- 2 Division of Endocrinology, Department of Internal Medicine, Shandong Provincial Qianfoshan Hospital, Shandong University , Jinan, China
| | - Xiaojun Zhou
- 2 Division of Endocrinology, Department of Internal Medicine, Shandong Provincial Qianfoshan Hospital, Shandong University , Jinan, China
| | - Jianjun Dong
- 4 Division of Endocrinology, Department of Internal Medicine, Qilu Hospital of Shandong University , Jinan, China
| | - Lin Liao
- 2 Division of Endocrinology, Department of Internal Medicine, Shandong Provincial Qianfoshan Hospital, Shandong University , Jinan, China
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Yang SC, Fu NK, Zhang J, Liang M, Cong HL, Lin WH, Tian FS, Lu CZ, Sun TT, Zhang WY, Ma ZH. Preventive Effects of Alprostadil Against Contrast-Induced Nephropathy Inpatients With Renal Insufficiency Undergoing Percutaneous Coronary Intervention. Angiology 2017; 69:393-399. [PMID: 29073785 DOI: 10.1177/0003319717730942] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Affiliation(s)
| | - Nai-Kuan Fu
- Department of Cardiology, Tianjin Chest Hospital, Tianjin, China
| | - Jing Zhang
- Department of Cardiology, Tianjin Chest Hospital, Tianjin, China
| | - Min Liang
- Tianjin Medical University, Tianjin, China
| | - Hong-Liang Cong
- Department of Cardiology, Tianjin Chest Hospital, Tianjin, China
| | - Wen-Hua Lin
- Department of Cardiology, Taida International Cardiovascular Hospital, Tianjin, China
| | - Feng-Shi Tian
- Department of Cardiology, Tianjin Fourth Central Hospital, Tianjin, China
| | - Cheng-Zhi Lu
- Department of Cardiology, Tianjin First Central Hospital, Tianjin, China
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Liang M, Yang S, Fu N, Lu C, Tian F, Xing X, Lin W, Liu J. Efficacy of alprostadil in preventing contrast-induced nephropathy in patients undergoing percutaneous coronary intervention: A multicenter prospective randomized controlled trial. Catheter Cardiovasc Interv 2017; 91:742-750. [PMID: 29024304 DOI: 10.1002/ccd.27353] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2017] [Revised: 08/22/2017] [Accepted: 09/02/2017] [Indexed: 12/20/2022]
Affiliation(s)
- Min Liang
- Graduate School of Tianjin Medical University; Tianjin China
| | - Shicheng Yang
- Department of Cardiology; Tianjin Chest Hospital; Tianjin China
| | - Naikuan Fu
- Graduate School of Tianjin Medical University; Tianjin China
- Department of Cardiology; Tianjin Chest Hospital; Tianjin China
| | - Chengzhi Lu
- Department of Cardiology; Tianjin First Central Hospital; Tianjin China
| | - Fengshi Tian
- Department of Cardiology; Tianjin Forth Central Hospital; Tianjin China
| | - Xiaochun Xing
- Department of Cardiology; Tianjin Forth Central Hospital; Tianjin China
| | - Wenhua Lin
- Department of Cardiology; Teda International Cardiovascular Hospital; Tianjin China
| | - Jingjing Liu
- Department of Cardiology; Teda International Cardiovascular Hospital; Tianjin China
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Wang J, Ai X, Li L, Gao Y, Sun N, Li C, Sun W. Alprostadil protects type 2 diabetes mellitus patients treated with metformin from contrast-induced nephropathy. Int Urol Nephrol 2017; 49:2019-2026. [DOI: 10.1007/s11255-017-1639-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2016] [Accepted: 06/19/2017] [Indexed: 12/24/2022]
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Zhang JZ, Kang XJ, Gao Y, Zheng YY, Wu TT, Li L, Liu F, Yang YN, Li XM, Ma YT, Xie X. Efficacy of alprostadil for preventing of contrast-induced nephropathy: A meta-analysis. Sci Rep 2017; 7:1045. [PMID: 28432310 PMCID: PMC5430773 DOI: 10.1038/s41598-017-01160-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2016] [Accepted: 03/27/2017] [Indexed: 12/20/2022] Open
Abstract
Contrast-induced nephropathy (CIN) has become the third-leading cause of hospital-acquired acute renal injury. Although alprostadil has been proposed as an effective preventative measure, this conclusion remains inconsistent. Thus, we performed a meta-analysis of the published studies on this topic to evaluate the preventative effect of alprostadil on CIN. Databases, including PubMed, the Web of Science, Cochrane Library, Wanfang, the China Biological Medicine Database (SinoMed) and the China National Knowledge Infrastructure (CNKI) were systematically searched. Nineteen clinical trials involving 2267 individuals were identified. We utilized a random or a fixed effect model to calculate the pooled odd ratios (ORs) and the standardized mean differences (SMD), respectively. Compared to the control group, the CIN risk decreased significantly in the alprostadil group (P < 0.00001, OR = 0.29, 95% CI = 0.21-0.39). In the subgroup of coronary angiography patients, the use of alprostadil also decreased the risk of CIN (P < 0.00001, OR = 0.27, 95% CI: 0.19-0.39). In conclusion, Alprostadil might be associated with a significant reduction in postcontrast Scr, BUN and CysC level and decrease the incidence of CIN.
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Affiliation(s)
- Jing-Zhan Zhang
- Department of Dermatology, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, P.R. China
| | - Xiao-Jing Kang
- Department of Dermatology, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, P.R. China
| | - Ying Gao
- Department of Cadre ward, First Affiliated Hospital of Xinjiang Medical University, Urumqi, 830054, P.R. China
| | - Ying-Ying Zheng
- Department of Cardiology, First Affiliated Hospital of Xinjiang Medical University, Urumqi, 830054, P.R. China
| | - Ting-Ting Wu
- Department of Cardiology, First Affiliated Hospital of Xinjiang Medical University, Urumqi, 830054, P.R. China
| | - Long Li
- Department of Cardiology, First Affiliated Hospital of Xinjiang Medical University, Urumqi, 830054, P.R. China
| | - Fen Liu
- Department of Cardiology, First Affiliated Hospital of Xinjiang Medical University, Urumqi, 830054, P.R. China
| | - Yi-Ning Yang
- Department of Cardiology, First Affiliated Hospital of Xinjiang Medical University, Urumqi, 830054, P.R. China
| | - Xiao-Mei Li
- Department of Cardiology, First Affiliated Hospital of Xinjiang Medical University, Urumqi, 830054, P.R. China
| | - Yi-Tong Ma
- Department of Cardiology, First Affiliated Hospital of Xinjiang Medical University, Urumqi, 830054, P.R. China
| | - Xiang Xie
- Department of Cardiology, First Affiliated Hospital of Xinjiang Medical University, Urumqi, 830054, P.R. China.
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Yang K, Liu W, Ren W, Lv S. Different interventions in preventing contrast-induced nephropathy after percutaneous coronary intervention. Int Urol Nephrol 2014; 46:1801-7. [PMID: 24966097 DOI: 10.1007/s11255-014-0765-3] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2014] [Accepted: 06/10/2014] [Indexed: 12/13/2022]
Abstract
BACKGROUND This study aimed to observe the preventive potential of different hydration solutions on contrast-induced nephropathy (CIN) after percutaneous coronary intervention. METHODS We initially screened 627 patients who were admitted to the Division of Cardiology, Beijing Anzhen Hospital between October 2010 and October 2011. The research subjects were randomly divided into four groups and were given: normal physiological saline (PS), sodium bicarbonate (SB), oral administration of PS + N-acetylcysteine (NAC) (PS + NAC), or oral administration of SB + NAC (SB + NAC). These patients were administered a hypotonic nonionic contrast agent, and the incidence of CIN in each group was observed. RESULTS The total incidence rate of CIN was 4.47 %, while the CIN incidence rates in the PS group, the SB group, the PS + NAC group and the SB + NAC group were 3.11, 5.03, 4.46 and 5.33 %, respectively. The differences between these groups were not statistically significant (P = 0.238), and for patients with diabetes and/or renal dysfunction, the incidence rates of CIN among the four groups did not show statistically significant differences (P = 0.238, 0.156, 0.287). CONCLUSION Use of PS, SB, and NAC caused no significant reduction in the incidence of CIN, but in high-risk patients with diabetes and/or renal dysfunction, SB + NAC might be superior to the application of isotonic crystalloid solution.
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Affiliation(s)
- Kun Yang
- Department of Coronary Care Unit (CCU), Capital Medical University Affiliated Beijing Anzhen Hospital, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing, 100029, China
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Li WH, Li DY, Qian WH, Liu JL, Xu TD, Zhu H, He HY. Prevention of contrast-induced nephropathy with prostaglandin E1 in high-risk patients undergoing percutaneous coronary intervention. Int Urol Nephrol 2014; 46:781-6. [PMID: 24570327 DOI: 10.1007/s11255-014-0674-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2013] [Accepted: 02/13/2014] [Indexed: 12/18/2022]
Abstract
PURPOSE Contrast-induced nephropathy (CIN) is an important complication in the use of iodinated contrast media. The present study aimed to assess the safety and efficacy of prostaglandin E1 (PGE1) in prevention of CIN in patients with high-risk factors undergoing percutaneous coronary intervention (PCI). METHODS The study group consisted of 163 patients who had undergone a coronary intervention procedure between January 1, 2012 and October 31, 2012. Study participants were randomly assigned to either the PGE1 group (82 patients) or the control group (81 patients). Patients in the PGE1 group received PGE1 intravenous infusion of 20 ng/kg/min for 6 h before and after the administration of contrast media. The control group received 0.9 % sodium chloride solution for routine hydration only. A nonionic, low-osmolality contrast agent was used in our laboratory at this time. Serum creatinine (Scr) values and estimated glomerular filtration rate were measured before and within 48 h of the administration of contrast agents. CIN was defined as an increase of ≥0.5 mg/dL or ≥ a 25 % increase in Scr concentrations over baseline within 48 h of angiography. RESULTS The amount of contrast agent administered was similar for the PGE1 and control groups (156 ± 63 vs. 161 ± 68 mL, P > 0.05). The incidence of CIN was lower in the PGE1 group than in the control group (3.7 vs. 11.1 %, P < 0.05). No serious adverse effects were observed. CONCLUSIONS In patients with high-risk factors undergoing PCI, the use of PGE1 for prevention of CIN is safe and efficacious.
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Affiliation(s)
- Wen-Hua Li
- Department of Cardiology, Affiliated Hospital of XuZhou Medical College, No. 99 Huaihai West Road, Xuzhou, 221002, China,
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Liu YH, Liu Y, Tan N, Chen JY, Chen J, Chen SH, He YT, Ran P, Ye P, Li Y. Predictive value of GRACE risk scores for contrast-induced acute kidney injury in patients with ST-segment elevation myocardial infarction before undergoing primary percutaneous coronary intervention. Int Urol Nephrol 2013; 46:417-26. [DOI: 10.1007/s11255-013-0598-5] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2013] [Accepted: 10/30/2013] [Indexed: 01/03/2023]
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