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Nardi G, Marchi E, Allinovi M, Lugli G, Biagiotti L, Di Muro FM, Valenti R, Muraca I, Tomberli B, Ciardetti N, Alterini B, Meucci F, Di Mario C, Mattesini A. Contrast-Induced Acute Kidney Injury in Patients with Heart Failure on Sodium-Glucose Cotransporter-2 Inhibitors Undergoing Radiocontrast Agent Invasive Procedures: A Propensity-Matched Analysis. J Clin Med 2024; 13:2041. [PMID: 38610806 PMCID: PMC11012317 DOI: 10.3390/jcm13072041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2024] [Revised: 03/20/2024] [Accepted: 03/27/2024] [Indexed: 04/14/2024] Open
Abstract
(1) Background: This single-center retrospective study aimed to evaluate whether sodium-glucose cotransporter-2 inhibitors (SGLT2-i) therapy may have a nephroprotective effect to prevent contrast-induced acute kidney injury (CI-AKI) in patients with heart failure (HF) undergoing iodinated contrast medium (ICM) invasive procedures. (2) Methods: The population was stratified into SGLT2-i users and SGLT2-i non-users according to the chronic treatment with gliflozins. The primary endpoint was CI-AKI incidence during hospitalization. Secondary endpoints were all-cause mortality and the need for continuous renal replacement therapy (CRRT). (3) Results: In total, 86 patients on SGLT2-i and 179 patients not on SGLT2-i were enrolled. The incidence of CI-AKI in the gliflozin group was lower than in the non-user group (9.3 vs. 27.3%, p < 0.001), and these results were confirmed after propensity matching analysis. Multivariable logistic regression showed that only SGLT2-i treatment was an independent preventive factor for CI-AKI (OR: 0.41, 95% CI: 0.16-0.90, p = 0.045). The need for CRRT was reported only in five patients in the non-SGLT2-i-user group compared to zero patients in the gliflozin group (p = 0.05). (4) Conclusions: SGLT2-i therapy was associated with a lower risk of CI-AKI in patients with HF undergoing ICM invasive procedures.
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Affiliation(s)
- Giulia Nardi
- Department of Experimental and Clinical Medicine, School of Human Health Sciences, Careggi University Hospital, University of Florence, 50134 Florence, Italy; (G.N.); (E.M.); (L.B.); (F.M.D.M.); (C.D.M.)
| | - Enrico Marchi
- Department of Experimental and Clinical Medicine, School of Human Health Sciences, Careggi University Hospital, University of Florence, 50134 Florence, Italy; (G.N.); (E.M.); (L.B.); (F.M.D.M.); (C.D.M.)
| | - Marco Allinovi
- Nephrology, Dialysis and Transplantation Unit, Careggi University Hospital, 50134 Florence, Italy
| | - Gianmarco Lugli
- Nephrology, Dialysis and Transplantation Unit, Careggi University Hospital, 50134 Florence, Italy
| | - Lucrezia Biagiotti
- Department of Experimental and Clinical Medicine, School of Human Health Sciences, Careggi University Hospital, University of Florence, 50134 Florence, Italy; (G.N.); (E.M.); (L.B.); (F.M.D.M.); (C.D.M.)
| | - Francesca Maria Di Muro
- Department of Experimental and Clinical Medicine, School of Human Health Sciences, Careggi University Hospital, University of Florence, 50134 Florence, Italy; (G.N.); (E.M.); (L.B.); (F.M.D.M.); (C.D.M.)
| | - Renato Valenti
- Division of Interventional Cardiology, Cardiothoracovascular Department, Careggi University Hospital, 50134 Florence, Italy; (R.V.); (I.M.)
| | - Iacopo Muraca
- Division of Interventional Cardiology, Cardiothoracovascular Department, Careggi University Hospital, 50134 Florence, Italy; (R.V.); (I.M.)
| | - Benedetta Tomberli
- Division of General Cardiology, Cardiothoracovascular Department, Careggi University Hospital, 50134 Florence, Italy;
| | - Niccolò Ciardetti
- Division of Structural Interventional Cardiology, Cardiothoracovascular Department, Careggi University Hospital, 50134 Florence, Italy; (N.C.); (F.M.); (A.M.)
| | - Brunetto Alterini
- Division of Cardiovascular and Perioperative Medicine, Cardiothoracovascular Department, Careggi University Hospital, 50134 Florence, Italy;
| | - Francesco Meucci
- Division of Structural Interventional Cardiology, Cardiothoracovascular Department, Careggi University Hospital, 50134 Florence, Italy; (N.C.); (F.M.); (A.M.)
| | - Carlo Di Mario
- Department of Experimental and Clinical Medicine, School of Human Health Sciences, Careggi University Hospital, University of Florence, 50134 Florence, Italy; (G.N.); (E.M.); (L.B.); (F.M.D.M.); (C.D.M.)
- Division of Structural Interventional Cardiology, Cardiothoracovascular Department, Careggi University Hospital, 50134 Florence, Italy; (N.C.); (F.M.); (A.M.)
| | - Alessio Mattesini
- Division of Structural Interventional Cardiology, Cardiothoracovascular Department, Careggi University Hospital, 50134 Florence, Italy; (N.C.); (F.M.); (A.M.)
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Santosa Y, Harca AD, Yuwono A, Hermanto A, Oliver MS, Sukmadja E, Soewardi R. Is It Safe to Do Percutaneous Coronary Intervention in Moderate to Severe Chronic Kidney Disease Patients? A Prospective Cohort Study. Cureus 2022; 14:e30312. [DOI: 10.7759/cureus.30312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/14/2022] [Indexed: 11/05/2022] Open
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El Hussein MT, Ha C. CHIPS: Prevention of contrast-induced nephropathy before and after cardiac catheterization. Nurse Pract 2021; 46:32-39. [PMID: 34808645 DOI: 10.1097/01.npr.0000804164.94431.fc] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
ABSTRACT Contrast-induced nephropathy is the leading cause of acute kidney injury in hospital settings. Practitioners must have a comprehensive understanding of preventive interventions. This article provides a mnemonic NPs can use to prevent contrast-induced nephropathy. The mnemonic, CHIPS, addresses Contrast minimizations, Hemofiltration, Iso-osmolar/low osmolar contrast, Pharmacologic interventions, and Saline I.V. hydration.
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Lipinski MJ, Satler LF. Contrast-induced nephropathy and peripheral intervention: Who's keeping track? Catheter Cardiovasc Interv 2017; 88:274-5. [PMID: 27530192 DOI: 10.1002/ccd.26699] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2016] [Accepted: 07/11/2016] [Indexed: 11/10/2022]
Abstract
The incidence of contrast-induced nephropathy is high at approximately 10% following peripheral angiography and intervention. The same measures taken to protect against contrast-induced nephropathy and acute kidney injury for coronary angiography and intervention should be applied for peripheral angiography and intervention. Greater or mandatory reporting to the Peripheral Vascular Intervention (PVI) Registry of the NCDR may not only better ascertain the true incidence of CIN in general practice, but to also provide benchmarks for institutions to improve patient outcomes.
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Affiliation(s)
- Michael J Lipinski
- Division of Interventional Cardiology, Medstar Washington Hospital Center, Washington, DC
| | - Lowell F Satler
- Division of Interventional Cardiology, Medstar Washington Hospital Center, Washington, DC
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