The Role of Diuretics and Angiotensin-converting enzyme inhibitors on Contrast- Induced Nephropathy in Patients after Percutaneous Coronary Intervention

BACKGROUND:
Nephropathy is one of the serious adverse effects in administration of contrast media in percutaneous coronary intervention (PCI). This study was designed in order to evaluate the effect of ACEI and diuretics on contrast- induced nephropathy.

METHODS:
This randomized clinical trial was conducted in Isfahan University of Medical Sciences in 2006. Overall, 60 persons were randomly assigned for each group. Groups A and B were treated by angiotensin converting enzyme inhibitors (ACEI) and groups C and D were treated by diuretics. In group A, ACEI was discontinued from 36 hours before PCI and in group C diuretics were discontinued as well. The post-intervention and the amount of increase in the serum creatinin (Cr) level were compared by ANOVA between groups.

FINDINGS:
The increase in Cr level was not significantly different between groups A and B (0.07±0.22 vs.,0.06±0.13 mg/dL , respectively, p=0.7). Similarly, this difference was not significant between groups C and D (0.08±0.17vs. 0.05±0.14mg/dL, respectively, p=0.2).

CONCLUSION:
Regarding to non- significant difference of Cr level between the groups either continuing or discontinuing ACEI and diuretics,in the presence of normal kidney function, these drugss,have no side effect in patients undergoing PCI.

KEY WORDS:
Contrast induced nephropathy, percutaneous coronary intervention