Efficacy and Safety of a Balanced Salt Solution Versus a 0.9% Saline Infusion for the Prevention of Contrast-Induced Acute Kidney Injury After Contrast-Enhanced Computed Tomography

Sehoon Park, Dong Ki Kim, Hee Yeon Jung, Chan Duck Kim, Jang Hee Cho, Ran hui Cha, Jong Cheol Jeong, Sejoong Kim, Hyung Jong Kim, Tae Hyun Ban, Byung Ha Chung, Jung Pyo Lee, Jung Tak Park, Seung Hyeok Han, Tae Hyun Yoo, Dong Ryeol Ryu, Sung Jin Moon, Jung Eun Lee, Wooseong Huh, Ea Wha KangTae Ik Chang, Kwon Wook Joo

Research output: Contribution to journalArticlepeer-review

Abstract

Rationale & Objective: We aimed to elucidate whether a balanced salt solution decreases the occurrence of contrast-induced acute kidney injury (CI-AKI) after contrast-enhanced computed tomography (CE-CT) as compared to 0.9% saline solution. Study Design: A randomized clinical trial. Setting & Participants: The study was performed in 14 tertiary hospitals in South Korea. Patients with estimated glomerular filtration rates (eGFRs) < 45 or <60 mL/min/1.73 m2 and additional risk factors (age ≥ 60 years or diabetes) who were undergoing scheduled CE-CT were included from December 2016 to December 2018. Intervention: An open-label intervention was performed. The study group received a balanced salt solution and the control group received 0.9% saline solution as prophylactic fluids for CE-CT. Outcomes: The primary outcome was CI-AKI, defined by creatinine level elevation ≥ 0.5 mg/dL or 25% from baseline within 48 to 72 hours after CE-CT. Secondary outcomes included AKI defined based on the KDIGO (Kidney Disease: Improving Global Outcomes) guideline, eGFR changes, death, or requiring dialysis within 6 months after CE-CT. Results: 493 patients received the study fluids. The control and study groups included 251 and 242 patients, respectively. The occurrence of CI-AKI in the study (10 [4.2%]) and control (17 [6.8%]) groups was not significantly different (P = 0.27). No significant difference was present for the secondary outcomes; AKI by the KDIGO definition (study: 19 [7.9%], control: 27 [10.8%]; P = 0.33), death/dialysis (study: 11 [4.7%], control: 9 [3.7%]; P = 0.74), and eGFR changes (study: 0.1 ± 0.2 mg/dL, control: 0.3 ± 2.8 mg/dL; P = 0.69). Limitations: This study failed to meet target enrollment. Conclusions: The risk for CI-AKI was similar after administration of a balanced salt solution and after use of 0.9% saline solution during CE-CT in higher-risk patients. Funding: This study was funded by CJ Healthcare (CS2015_0046). Trial Registration: Registered at ClinicalTrials.gov with study number NCT02799368.

Original languageEnglish
Pages (from-to)189-195
Number of pages7
JournalKidney Medicine
Volume2
Issue number2
DOIs
Publication statusPublished - 2020 Mar 1

Bibliographical note

Funding Information:
This study is funded by CJ Healthcare Corporation ( CS2015_0046 ), Seoul, Korea. The funder did not have any role in study design; collection, analysis, or interpretation of data; writing the report; or the decision to submit the report for publication.

All Science Journal Classification (ASJC) codes

  • Internal Medicine
  • Nephrology

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