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Submitted: 10 Jun 2019
Accepted: 15 Aug 2019
ePublished: 13 Sep 2019
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J Renal Inj Prev. 2019;8(4): 283-288.
doi: 10.15171/jrip.2019.52

Scopus ID: 85076318962
  Abstract View: 3096
  PDF Download: 1122

Original Article

Impact of oxygen therapy to ameliorate contrast-induced nephropathy in patients with acute coronary syndrome undergoing emergency angiography; a double-blinded clinical trial

Tahere Zarouk Ahimahalle 1 ORCID logo, Abdollah Amirfarhangi 2 ORCID logo, Mosadegh Jabbari 1 ORCID logo, Aria Jenabi 1 ORCID logo, Hadia Bagherzadegan 1 ORCID logo, Giti Noghabaei 3* ORCID logo

1 Internal Medicine Department, Iran University of Medical Sciences, Tehran, Iran
2 Department of Cardiology, Iran University of Medical Sciences, Tehran, Iran
3 Rasoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
*Corresponding Author: Email: Gitinoghabaei@gmail.com

Abstract

Introduction: Contrast-induced nephropathy (CIN) is one of the major causes of acute kidney injury.

Objectives: Regarding an increase in mortality and morbidity in patients with CIN, this study aimed to evaluate the effect of oxygen therapy in prevention of the CIN in individuals with acute coronary syndrome undergoing emergent angiography.

Patients and Methods: This study was a double-blinded clinical trial with control group (parallel design), randomized, and with a sample size of 204 individuals conducted on male or female patients over 35 years old and suspected of coronary artery disease undergoing emergent angiography refereed to Rasoul Akram hospital in 2018. Participants were divided into 2 groups (supplementary oxygen and oxygen-free groups). The first group received two to three liters of oxygen per minute from 10 minutes before the start of the procedure until the end of the procedure, and the second group inhaled the oxygen in the room air. Arterial blood gas (ABG) was taken prior to receiving oxygen and at the end of the procedure. Serum creatinine level was tested for all individuals before and 48 hours after the procedure.

Results: The mean age in intervention and control groups was 61.66 ± 14.64 years and 60.49 ± 11.59 years, respectively (P=0.54). Mean glomerular filtration rate (GFR) and serum creatinine before and after angiography was not significantly different (P>0.05). There was a significant difference between the two genders regarding the development of CIN (P=0.002), which was higher in women from that of men. Female gender was a strong risk factor and approximately increased four times the risk of CIN (OR = 4.1; (P=0.001). History of chronic kidney disease (CKD) and hypertension (HTN) also produced such a situation (OR = 22.37; P=0.007).

Conclusion: According to the results, oxygen therapy has no effect on the occurrence of CIN. It is also found that female gender, history of CKD and hypertension are risk factors for CIN.


Implication for health policy/practice/research/medical education:

Recent studies have suggested that the addition of supplemental oxygen to hydration leads to a significant reduction in CIN development. Reducing the risk of CIN with oxygen supplementation has been very much taken into consideration because of its safe nature for the patients and its availability. This study showed that oxygen therapy has no effect on the occurrence of CIN before and during emergency angiography. Based on small-sized samples and a set of studies in one center, it is required to study in a larger population and multiple centers for determination of using supplementary oxygen in the prevention of CIN.

Please cite this paper as: Ahimahalle T, Amirfarhangi A, Jabbari M, Jenabi A, Bagherzadegan H, Noghabaei G. Impact of oxygen therapy to ameliorate contrast-induced nephropathy in patients with acute coronary syndrome undergoing emergency angiography; a double-blinded clinical trial. J Renal Inj Prev. 2019;8(4):283-288. DOI: 10.15171/jrip.2019.52.

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