నైరూప్య

Comparison of the effect of intravenous saline hydration on serum creatinine concentration between patients with or without iodine contrast administration

Rzezniczak Janusz, Synowiec Tomasz, Hiczkiewicz Jarosław, Slomczynski Marek, Dariusz Angerer, Palasz Anna, Jakub Zurawski, Burchardt Pawel

Objective: The aim of the project is to determine influence of intravenous prophylactic hydration on serum creatinine (SCR) levels changes in healthy subjects who have been hospitalized (without iodine contrast administration). The project also aims to compare the effects of intravenous hydration on the SCR levels in subjects with and without iodine contrast administration. Existing data in this regard are very scarce.

Materials and Methods: We used retrospective clinical as well as laboratory data from 391 patients. 50 healthy subjects were included in the EXPERIMENTAL group. They were intravenously hydrated before surgical treatment of hernia iunginalis. SCR were measured at admission and 24 h later. The remaining 341 subjects (CONTROL group) underwent elective coronary angiography/ angioplasty, received a prophylactic hydration and had serum creatinine concentration measured prior to and 12-18 h after the invasive procedure with iodine contrast administration.

Results: In EXPERIMENTAL group the results for SCR at admission and after hydration (but before surgical procedure) were as follows (mg/dl) (0.72 ± 0.18 vs. 0.75 ± 0.18 p=0.006). In CONTROL group the SCR measured prior to and 12-18 h after the invasive procedure with iodine contrast administration were as follows (mg/dl) (0.94 ± 0.45 vs. 0.87 ± 0.45, p<0.001). The results were significantly different between these groups (341/91 vs. 50/37, p<0.001).

Conclusion: After 24 h intravenous hydration in healthy individuals, can lead to serum creatinine increase, probably due to over diuresis (we may only speculate that). This effect is significantly less frequent in patients exposed to intra-arterial iodine contrast administration with the same dose and manner of prophylactic irrigation.