Prevention of Contrast Induced Nephropathy (NIC) by Intravenous Versus Oral Rehydration - Full Text View

Purpose

The purpose of this study is to compare the efficacy of oral versus intravenous hydration in the prevention of the contrast-induced nephropathy.

Condition	Intervention
KIDNEY FAILURE, ACUTE	Other: Intravenous hydration with bicarbonate Other: Oral hydration with Sodium solution

Study Type:	Interventional
Study Design:	Allocation: Randomized Endpoint Classification: Efficacy Study Intervention Model: Parallel Assignment Masking: Open Label Primary Purpose: Prevention
Official Title:	Comparative Efficacy of the Application of an Oral/iv Hydration Protocol in the Prevention of Contrast Induced Nephropathy

Further study details as provided by Clinica Universidad de Navarra, Universidad de Navarra:

Primary Outcome Measures:

To compare the efficacy of oral versus intravenous hydration in the prevention of the contrast-induced nephropathy (CIN) in inpatients with different renal function. [ Time Frame: 24 h ] [ Designated as safety issue: Yes ]

Secondary Outcome Measures:

Study in vitro, the effect of contrast on NADPH-oxidase activity of PBLs isolated from 30 patients will be included in the study (10 patients by each group). [ Time Frame: 24 h ] [ Designated as safety issue: Yes ]

Enrollment:	167
Study Start Date:	September 2008
Study Completion Date:	June 2012
Primary Completion Date:	June 2012 (Final data collection date for primary outcome measure)

Arms	Assigned Interventions
Experimental: (I) BICARBONATE INTRAVENOUS INFUSION Intravenous hydration with bicarbonate 1/6 M intravenous infusion (3ml/Kg/h) one hour before the administration of intravenous contrast	Other: Intravenous hydration with bicarbonate Intravenous hydration with bicarbonate 1/6 M intravenous infusion (3ml/Kg/h) one hour before the administration of intravenous contrast
Active Comparator: (II) ORAL SODIUM SOLUTION Oral hydration with Sodium solution (Casen solution of rehydratation) in the 4 hours before of the intravenous contrast administration (75 ml/10 kg as equivalent to 0,25 g of sodium chloride /10 kg).	Other: Oral hydration with Sodium solution Oral hydration with Sodium solution (Casen solution of rehydration) in the 4 hours before of the intravenous contrast administration (75 ml/10 kg as equivalent to 0,25 g of sodium chloride /10 kg).

Detailed Description:

Objective: To compare the efficacy of oral versus intravenous hydration in the prevention of the contrast-induced nephropathy (CIN) in inpatients with different renal function and equal type and volume of contrast.

Methods: The clinical trial will include 324 patients with GFR higher or equal to 30 ml/min who will receive intravenous contrast (Iohexol: 300 mg of l/ml; approximate volume: 120 ml at 2-5ml/second) in the following 12-24 hours. Patients with inclusion criteria, and having previously signed a consent form, will be randomised into 3 groups (intravenous hydration, oral and no hydration). Intravenous hydration will be carried out with bicarbonate 1/6M one hour before the test (3ml/Kg/h) and oral hydration with Casen solution in will be carried out 4 hours before (75 ml/10 kg) the intravenous contrast administration. In relation to the hydrated, it should be pointed out that, the same procedure would have been carried out without the study. The follow-up of renal function will be carried out after measuring creatinine and cystatin C in blood and GFR pre- and 24 hour after the test. It will also determine neutrophil gelatinase-associated lipocalin (N-GAL), IL-8 and F2-Isoprostanes levels in urine and superoxide dismutase activity in erythrocytes, pre- and in different post- test times.

Also, in vitro, the effect of contrast on NADPH-oxidase activity of PBLs isolated from 30 control patients will also be studied (10 patients by each group).

Eligibility

Ages Eligible for Study:	18 Years and older
Genders Eligible for Study:	Both
Accepts Healthy Volunteers:	No

Criteria

Inclusion Criteria:

Hospitalized patients
aged less than 18 years
provision for the performance of IV contrast (120-150 ml) within 12-24 h.

Exclusion Criteria:

Nephropathy patients with stage 4-5 according to the classification of Chronic Kidney Disease (CKD) of the U.S. National Kidney Foundation's Kidney Disease Outcome Quality Initiative (NKF-KDOQI). The GFR is estimated by the formula Modification Diet Renal Diseases Study (MDRD).
Patients undergoing: cardiac catheterization or other proceeding in contrast with the previous week, colonoscopy in 48 hours or have received prior nephrotoxic (aminoglycosides and / or certain chemotherapeutic agents) 24-48 hours before the test or in hours.

Contacts and Locations

Please refer to this study by its ClinicalTrials.gov identifier: NCT00908843

Locations

Spain
Clinica Universidad de Navarra
Pamplona, Navarra, Spain, 31008

Sponsors and Collaborators

Clinica Universidad de Navarra, Universidad de Navarra

Investigators

Study Director:

Nuria García-Fernández, MD, Ph.D.

Clínica Universidad de Navarra

More Information

No publications provided

Responsible Party:	Clinica Universidad de Navarra, Universidad de Navarra
ClinicalTrials.gov Identifier:	NCT00908843 History of Changes
Other Study ID Numbers:	NIC2117, 2117/2007, EC08/00203
Study First Received:	May 25, 2009
Last Updated:	June 7, 2012
Health Authority:	Spain: Spanish Agency of Medicines

Keywords provided by Clinica Universidad de Navarra, Universidad de Navarra:

Contrast nephropathy
Renal failure

Additional relevant MeSH terms:

Kidney Diseases
Acute Kidney Injury
Renal Insufficiency
Urologic Diseases

ClinicalTrials.gov processed this record on June 17, 2013