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Contrast induced nephropathy (CIN) is an increasing problem in cardiology invasive imaging, limited by the absence of treatment and few prevention methods. Anti oxidant benefits of ascorbic acid have been reported by small series but evidence remains poor.
To evaluate the effect of ascorbic acid administration in CIN occurrence in patients undergoing coronarography.
Patients undergoing coronarography between March and November 2010 were prospectively and blindly randomized to control group receiving a standard CIN prevention protocol including saline hydration and ascorbic acid group receiving saline hydration with ascorbic acid (3g 2hours before the procedure then 2g the day after and next day). We excluded patients requiring hemodialysis, those with acute renal insufficiency, heart failure with LVEF ≤ 40%, digestive resections, and previous contrast medium injection and aspirin or ascorbic acid intake. Endpoint was occurrence of CIN defined as a 25% raise of creatinine level 48 to 72 h after coronarography.
Two hundred two patients were included, 95 in control group and 107 in ascorbic acid group. Mean age was 66 years and 60% were men. Baseline characteristics were similar between the two groups. Creatinin level before intervention was 98.6 ± 29 μmol/l and contrast medium administrated was 71.6 ± 25 ml. CIN occurred in 31 (15.3%) patients. It was significantly lower in ascorbic acid group (10.3% vs 21.1%, p=0.03).
Ascorbic acid showed to reduce CIN incidence in patients undergoing coronarography compared with saline hydration alone.
- 2013 American College of Cardiology Foundation