Comparison of oral and intravenous hydration strategies for the prevention of contrast-induced nephropathy in patients undergoing coronary angiography or angioplasty: a randomized clinical trial

Abstract

OBJECTIVE: The efficacy of oral hydration in the prevention of contrast-induced nephropathy in patients undergoing elective coronary intervention is unclear. METHODS: A total of 120 patients were randomly assigned to three groups. Group A (n = 40) received intravenous hydration before and after coronary angiography or angioplasty. Group B (n = 40) received oral tap water before and after the procedures, whereas group C (n = 40) received only postprocedural drinking water. Levels of serum creatinine and urea nitrogen were measured before, 12 hours after, 2 and 3 days after the coronary angiography or angioplasty. RESULTS: : There was no statistically significant difference in the age, sex, baseline renal function and the volume of contrast medium used during the coronary procedures among the three groups (P > 0.05).There was no statistically significant difference in the mean serum creatinine or urea nitrogen among the three groups 12 hours, and 3 days after the coronary procedures ( P > 0.05).The incidence of contrast-induced nephropathy in group A, B and C was 5.0% (2/40), 7.5% (3/40) and 5.0% (2/40), respectively (P = 0.86). Renal function in the seven patients who experienced contrast-induced nephropathy recovered within a week following rehydration treatment. CONCLUSIONS: Pre- and post-procedural oral hydration was as effective as intravenous rehydration in the prevention of contrast-induced nephropathy in patients undergoing coronary angiography or angioplasty.