Navigation Links
Results of the POSEIDON trial presented at TCT 2012
Date:10/25/2012

MIAMI, FL OCTOBER 25, 2012 A hydration regimen tailored to the patient's fluid status was effective in reducing damage to kidneys in patients undergoing cardiac catheterization, according to a study presented at the 24th annual Transcatheter Cardiovascular Therapeutics (TCT) scientific symposium, sponsored by the Cardiovascular Research Foundation. TCT is the world's premier educational meeting specializing in interventional cardiovascular medicine.

Contrast-induced acute kidney injury (CI-AKI), or contrast-induced nephropathy, refers to kidney damage that may occur due to the use of contrast dye that is necessary for visualization during catheterization and other procedures. Hydration remains the cornerstone for the prevention of kidney damage. However, there are no well-defined practical hydration protocols available for the prevention of CI-AKI. The Prevention of Contrast Renal Injury with Different Hydration Strategies (POSEIDON) trial investigated a novel sliding scale hydration protocol based upon routine invasively obtained left ventricular end-diastolic pressure measurements (LVEDP) in patients undergoing cardiac catheterization.

Patients undergoing coronary angiography with stable renal insufficiency (an estimated GFR <60 mL/min/1.73m2) and one additional CI-AKI risk factor were randomized 1:1 to an LVEDP guided hydration strategy or a standard hydration strategy.

Both groups received 0.9 percent saline at 3 mL/kg for at least one hour prior to cardiac catheterization. The LVEDP was measured in all patients at the start of the procedure and prior to contrast administration. In the LVEDP group, the fluid rate was adjusted according to the patients' LVEDP as follows: 5 mL/kg/hr for LVEDP <13 mmHg; 3 mL/kg/hr for 13-18 mmHg; 1.5 mL/kg/hr for >18 mmHg.

The standard hydration group was hydrated at 1.5 mL/kg/hr. The fluid rate was set at the start of the procedure (prior to contrast exposure), continued during the procedure, and for four hours post-procedure. The primary outcome, CI-AKI, was defined as a greater than 25 percent or greater than 0.5 mg/dl increase in serum creatinine an indicator of kidney damage up to four days post-procedure.

There were 396 patients randomized, 196 in the LVEDP group and 200 in the standard hydration group. Kidney damage was found in 6.7 percent of the LVEDP guided hydration group and in 16.3 percent of the standard hydration group (P = 0.005). There were no significant differences between groups for baseline renal function or LVEDP. The relative risk (95 percent confidence interval) for LVEDP-guided hydration versus standard hydration was 0.41 (0.22-0.79). The absolute risk difference was -9.5 percent in favor of LVEDP guided hydration; therefore, 11 patients would need to be treated to prevent one CI-AKI event.

"This is the first trial to test the hypothesis of a left ventricular end diastolic pressure-guided hydration strategy for prevention of contrast nephropathy. We found that this technique resulted in a significant 59 percent relative and 10 percent absolute reduction in contrast nephropathy," said lead researcher Somjot Brar, MD, MPH. Dr. Brar is an Interventional Cardiologist & Vascular Specialist at Kaiser Permanente in Los Angeles, CA and an Assistant Clinical Professor of Medicine at the University of California, Los Angeles.

"This is an easily implemented protocol that can be readily adapted in both inpatient and outpatient settings," Dr. Brar said.


'/>"/>
Contact: Judy Romero
jromero@crf.org
Cardiovascular Research Foundation
Source:Eurekalert

Related medicine news :

1. 1-year results of ADAPT-DES presented at TCT 2012
2. Comparison of Obesity Surgeries Turns Up Surprising Results
3. Results from study of Mead Johnsons Enfamil® Human Milk Fortifier Acidified Liquid published in Pediatrics
4. Missed Diagnoses in ICU Often Have Deadly Results: Review
5. Anti-clotting drugs yield similar results
6. Late-Night Cramming May Hurt School Test Results
7. New survey: Women want to SEE breast reconstruction results before cancer surgery
8. Weight-loss surgery results in positive changes in social life, medical conditions
9. Many Test Results Left Unread as Patients Leave Hospital: Study
10. 7-Day Stuttering Therapy May Get Results, Study Says
11. Swaziland HIV incidence results announced at AIDS 2012
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:6/25/2016)... ... June 25, 2016 , ... Conventional wisdom preaches the benefits of moderation, whether ... latter, setting the bar too high can result in disappointment, perhaps even self-loathing. However, ... their goal. , Research from PsychTests.com reveals that behind the tendency ...
(Date:6/24/2016)... ... June 24, 2016 , ... Those who have experienced traumatic events may suffer ... unhealthy avenues, such as drug or alcohol abuse, as a coping mechanism. To avoid ... healthy coping following a traumatic event. , Trauma sufferers tend to feel a range ...
(Date:6/24/2016)... ... ... Marcy was in a crisis. Her son James, eight, was out of control. Prone to ... , “When something upset him, he couldn’t control his emotions,” remembers Marcy. “If there ... my other children and say he was going to kill them. If we were ...
(Date:6/24/2016)... ... 2016 , ... Global law firm Greenberg Traurig, P.A. announced that 20 Florida ... their peers for this recognition are considered among the top 2 percent of lawyers ... as members of this year’s Legal Elite Hall of Fame: Miami Shareholders Mark ...
(Date:6/24/2016)... CA (PRWEB) , ... June 24, 2016 , ... Comfort ... the American Cancer Society and the Road To Recovery® program to drive cancer patients ... seniors and other adults to ensure the highest quality of life and ongoing independence. ...
Breaking Medicine News(10 mins):
(Date:6/26/2016)... , June 27, 2016  VMS Rehab Systems, Inc. ... will take whatever measures required to build a strong ... which is currently listed on the OTC Markets-pink current ... Chairman and CEO, "We are seeing an anomaly in ... understand, not only by the Company, but shareholders and ...
(Date:6/24/2016)... 2016  Consumers have taken a more active ... more emphasis on patient outcomes. ... the pharmaceutical industry have evolved beyond just providing ... are focusing on becoming more patient-oriented across their ... services that improve health. ...
(Date:6/24/2016)... FRANCISCO, Calif. , June 24, 2016 /PRNewswire/ ... ), a biopharmaceutical company developing novel therapeutics for ... unmet needs, today announced the closing of its ... of common stock, at the public offering price ... in the offering were offered by GBT. GBT ...
Breaking Medicine Technology: