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The role of theophylline in contrast‐induced nephropathy: a case‐control study

Background. Various strategies for the prevention of contrast‐induced nephropathy (CN) have been studied, with conflicting results. Adenosine may play an important role in the pathogenesis of CN. This study prospectively assessed the role of oral theophylline in the prevention of CN. Methods. We ran...

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Published in:Nephrology, dialysis, transplantation dialysis, transplantation, 2002-11, Vol.17 (11), p.1936-1941
Main Authors: Kapoor, Aditya, Kumar, Sudeep, Gulati, Sanjeev, Gambhir, Sanjay, Sethi, Ravindra S., Sinha, Nakul
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container_end_page 1941
container_issue 11
container_start_page 1936
container_title Nephrology, dialysis, transplantation
container_volume 17
creator Kapoor, Aditya
Kumar, Sudeep
Gulati, Sanjeev
Gambhir, Sanjay
Sethi, Ravindra S.
Sinha, Nakul
description Background. Various strategies for the prevention of contrast‐induced nephropathy (CN) have been studied, with conflicting results. Adenosine may play an important role in the pathogenesis of CN. This study prospectively assessed the role of oral theophylline in the prevention of CN. Methods. We randomized into two groups 70 patients with diabetes mellitus who were undergoing coronary angiography (CAG) with high‐osmolar contrast media. Group I (n=35) underwent routine CAG, and group II (n=35) received oral theophylline 200 mg b.d. 24 h before and for 48 h after CAG. Serum Na+, K+, blood urea nitrogen (BUN), creatinine, osmolality, glomerular filtration rate (GFR) and urinalysis were performed before and after CAG. The 99mTc‐DTPA‐clearance method was used to assess GFR. Results. Following angiography, patients in the control group showed a significant rise in serum creatinine (1.19±0.23 vs 1.44±0.32 mg/dl, P=0.003) and BUN (13.95±2.61 vs 17.55±3.9 mg/dl, P=0.01) along with a fall in GFR (85.4±14.7 vs 66.85±14.8 ml/min, P=0.008). The mean percentage fall in GFR was 35.8%. There was no significant change in serum creatinine (1.16±0.18 vs 1.24±0.21 mg/dl), BUN (12.8±3.36 vs 14.8±2.5 mg/dl) and GFR (86.8±15.8 vs 80.3±16.0 ml/min) in those receiving theophylline. No patient in the theophylline group had a >25% rise in serum creatinine, compared with 7/35 in the control group (P=0.017). In the control group, 11/35 (31%) developed CN, as demonstrated by a ⩾25% fall in GFR, while only one patient in the theophylline group had a fall in GFR (P=0.004). None of the pre‐angiographic variables could predict the development of CN. Conclusions. Following the use of high‐osmolar contrast media for routine CAG, CN may develop in 31% of diabetic patients. Patients who received prophylactic oral theophylline had a significantly lower risk of CN than those who did not.
doi_str_mv 10.1093/ndt/17.11.1936
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Adenosine may play an important role in the pathogenesis of CN. This study prospectively assessed the role of oral theophylline in the prevention of CN. Methods. We randomized into two groups 70 patients with diabetes mellitus who were undergoing coronary angiography (CAG) with high‐osmolar contrast media. Group I (n=35) underwent routine CAG, and group II (n=35) received oral theophylline 200 mg b.d. 24 h before and for 48 h after CAG. Serum Na+, K+, blood urea nitrogen (BUN), creatinine, osmolality, glomerular filtration rate (GFR) and urinalysis were performed before and after CAG. The 99mTc‐DTPA‐clearance method was used to assess GFR. Results. Following angiography, patients in the control group showed a significant rise in serum creatinine (1.19±0.23 vs 1.44±0.32 mg/dl, P=0.003) and BUN (13.95±2.61 vs 17.55±3.9 mg/dl, P=0.01) along with a fall in GFR (85.4±14.7 vs 66.85±14.8 ml/min, P=0.008). The mean percentage fall in GFR was 35.8%. There was no significant change in serum creatinine (1.16±0.18 vs 1.24±0.21 mg/dl), BUN (12.8±3.36 vs 14.8±2.5 mg/dl) and GFR (86.8±15.8 vs 80.3±16.0 ml/min) in those receiving theophylline. No patient in the theophylline group had a &gt;25% rise in serum creatinine, compared with 7/35 in the control group (P=0.017). In the control group, 11/35 (31%) developed CN, as demonstrated by a ⩾25% fall in GFR, while only one patient in the theophylline group had a fall in GFR (P=0.004). None of the pre‐angiographic variables could predict the development of CN. Conclusions. Following the use of high‐osmolar contrast media for routine CAG, CN may develop in 31% of diabetic patients. Patients who received prophylactic oral theophylline had a significantly lower risk of CN than those who did not.</description><identifier>ISSN: 0931-0509</identifier><identifier>ISSN: 1460-2385</identifier><identifier>EISSN: 1460-2385</identifier><identifier>DOI: 10.1093/ndt/17.11.1936</identifier><identifier>PMID: 12401850</identifier><language>eng</language><publisher>England: Oxford University Press</publisher><subject>acute renal failure ; Administration, Oral ; Adult ; Aged ; angiography ; Blood Urea Nitrogen ; cardiac catheterization ; Case-Control Studies ; Contrast Media - adverse effects ; Coronary Angiography ; Creatinine - blood ; Diabetes Mellitus - diagnostic imaging ; Diatrizoate Meglumine - adverse effects ; Glomerular Filtration Rate - drug effects ; Humans ; Incidence ; Kidney Diseases - chemically induced ; Kidney Diseases - epidemiology ; Kidney Diseases - prevention &amp; control ; Middle Aged ; radiocontrast‐induced nephropathy ; renal haemodynamics ; theophylline ; Theophylline - administration &amp; dosage</subject><ispartof>Nephrology, dialysis, transplantation, 2002-11, Vol.17 (11), p.1936-1941</ispartof><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c369t-6cf511bd1445903e2331b949ea12070c6e6fbc2ff3c410bc72e3cbd32a428d0f3</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27900,27901</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/12401850$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kapoor, Aditya</creatorcontrib><creatorcontrib>Kumar, Sudeep</creatorcontrib><creatorcontrib>Gulati, Sanjeev</creatorcontrib><creatorcontrib>Gambhir, Sanjay</creatorcontrib><creatorcontrib>Sethi, Ravindra S.</creatorcontrib><creatorcontrib>Sinha, Nakul</creatorcontrib><title>The role of theophylline in contrast‐induced nephropathy: a case‐control study</title><title>Nephrology, dialysis, transplantation</title><addtitle>Nephrol. Dial. Transplant</addtitle><description>Background. Various strategies for the prevention of contrast‐induced nephropathy (CN) have been studied, with conflicting results. Adenosine may play an important role in the pathogenesis of CN. This study prospectively assessed the role of oral theophylline in the prevention of CN. Methods. We randomized into two groups 70 patients with diabetes mellitus who were undergoing coronary angiography (CAG) with high‐osmolar contrast media. Group I (n=35) underwent routine CAG, and group II (n=35) received oral theophylline 200 mg b.d. 24 h before and for 48 h after CAG. Serum Na+, K+, blood urea nitrogen (BUN), creatinine, osmolality, glomerular filtration rate (GFR) and urinalysis were performed before and after CAG. The 99mTc‐DTPA‐clearance method was used to assess GFR. Results. Following angiography, patients in the control group showed a significant rise in serum creatinine (1.19±0.23 vs 1.44±0.32 mg/dl, P=0.003) and BUN (13.95±2.61 vs 17.55±3.9 mg/dl, P=0.01) along with a fall in GFR (85.4±14.7 vs 66.85±14.8 ml/min, P=0.008). The mean percentage fall in GFR was 35.8%. There was no significant change in serum creatinine (1.16±0.18 vs 1.24±0.21 mg/dl), BUN (12.8±3.36 vs 14.8±2.5 mg/dl) and GFR (86.8±15.8 vs 80.3±16.0 ml/min) in those receiving theophylline. No patient in the theophylline group had a &gt;25% rise in serum creatinine, compared with 7/35 in the control group (P=0.017). In the control group, 11/35 (31%) developed CN, as demonstrated by a ⩾25% fall in GFR, while only one patient in the theophylline group had a fall in GFR (P=0.004). None of the pre‐angiographic variables could predict the development of CN. Conclusions. Following the use of high‐osmolar contrast media for routine CAG, CN may develop in 31% of diabetic patients. Patients who received prophylactic oral theophylline had a significantly lower risk of CN than those who did not.</description><subject>acute renal failure</subject><subject>Administration, Oral</subject><subject>Adult</subject><subject>Aged</subject><subject>angiography</subject><subject>Blood Urea Nitrogen</subject><subject>cardiac catheterization</subject><subject>Case-Control Studies</subject><subject>Contrast Media - adverse effects</subject><subject>Coronary Angiography</subject><subject>Creatinine - blood</subject><subject>Diabetes Mellitus - diagnostic imaging</subject><subject>Diatrizoate Meglumine - adverse effects</subject><subject>Glomerular Filtration Rate - drug effects</subject><subject>Humans</subject><subject>Incidence</subject><subject>Kidney Diseases - chemically induced</subject><subject>Kidney Diseases - epidemiology</subject><subject>Kidney Diseases - prevention &amp; control</subject><subject>Middle Aged</subject><subject>radiocontrast‐induced nephropathy</subject><subject>renal haemodynamics</subject><subject>theophylline</subject><subject>Theophylline - administration &amp; dosage</subject><issn>0931-0509</issn><issn>1460-2385</issn><issn>1460-2385</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2002</creationdate><recordtype>article</recordtype><recordid>eNpFkMFKw0AURQdRbK1uXcr8QNL3ZpJM4k6KtkJB0CrSzTCZTEg0TcJMCmbnJ_iNfompLbq6i3vuXRxCLhF8hIRP66ybovARfUx4dETGGETgMR6Hx2Q8AOhBCMmInDn3BgAJE-KUjJAFgHEIY_K4Kgy1TWVok9OuME1b9FVV1oaWNdVN3Vnluu_Pr7LOttpktDZtYZtWdUV_TRXVypmh_QWbirpum_Xn5CRXlTMXh5yQ57vb1WzhLR_m97Obpad5lHRepPMQMc0wCMIEuGGcY5oEiVHIQICOTJSnmuU51wFCqgUzXKcZZypgcQY5nxB__6tt45w1uWxtuVG2lwhyJ0cOciQKiSh3cobB1X7QbtONyf7xg40B8PZA6Trz8dcr-y4jwUUoF69rOXtZC_YUg5zzH_wEcjk</recordid><startdate>200211</startdate><enddate>200211</enddate><creator>Kapoor, Aditya</creator><creator>Kumar, Sudeep</creator><creator>Gulati, Sanjeev</creator><creator>Gambhir, Sanjay</creator><creator>Sethi, Ravindra S.</creator><creator>Sinha, Nakul</creator><general>Oxford University Press</general><scope>BSCLL</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope></search><sort><creationdate>200211</creationdate><title>The role of theophylline in contrast‐induced nephropathy: a case‐control study</title><author>Kapoor, Aditya ; Kumar, Sudeep ; Gulati, Sanjeev ; Gambhir, Sanjay ; Sethi, Ravindra S. ; Sinha, Nakul</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c369t-6cf511bd1445903e2331b949ea12070c6e6fbc2ff3c410bc72e3cbd32a428d0f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2002</creationdate><topic>acute renal failure</topic><topic>Administration, Oral</topic><topic>Adult</topic><topic>Aged</topic><topic>angiography</topic><topic>Blood Urea Nitrogen</topic><topic>cardiac catheterization</topic><topic>Case-Control Studies</topic><topic>Contrast Media - adverse effects</topic><topic>Coronary Angiography</topic><topic>Creatinine - blood</topic><topic>Diabetes Mellitus - diagnostic imaging</topic><topic>Diatrizoate Meglumine - adverse effects</topic><topic>Glomerular Filtration Rate - drug effects</topic><topic>Humans</topic><topic>Incidence</topic><topic>Kidney Diseases - chemically induced</topic><topic>Kidney Diseases - epidemiology</topic><topic>Kidney Diseases - prevention &amp; control</topic><topic>Middle Aged</topic><topic>radiocontrast‐induced nephropathy</topic><topic>renal haemodynamics</topic><topic>theophylline</topic><topic>Theophylline - administration &amp; dosage</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kapoor, Aditya</creatorcontrib><creatorcontrib>Kumar, Sudeep</creatorcontrib><creatorcontrib>Gulati, Sanjeev</creatorcontrib><creatorcontrib>Gambhir, Sanjay</creatorcontrib><creatorcontrib>Sethi, Ravindra S.</creatorcontrib><creatorcontrib>Sinha, Nakul</creatorcontrib><collection>Istex</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><jtitle>Nephrology, dialysis, transplantation</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kapoor, Aditya</au><au>Kumar, Sudeep</au><au>Gulati, Sanjeev</au><au>Gambhir, Sanjay</au><au>Sethi, Ravindra S.</au><au>Sinha, Nakul</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The role of theophylline in contrast‐induced nephropathy: a case‐control study</atitle><jtitle>Nephrology, dialysis, transplantation</jtitle><addtitle>Nephrol. Dial. Transplant</addtitle><date>2002-11</date><risdate>2002</risdate><volume>17</volume><issue>11</issue><spage>1936</spage><epage>1941</epage><pages>1936-1941</pages><issn>0931-0509</issn><issn>1460-2385</issn><eissn>1460-2385</eissn><abstract>Background. Various strategies for the prevention of contrast‐induced nephropathy (CN) have been studied, with conflicting results. Adenosine may play an important role in the pathogenesis of CN. This study prospectively assessed the role of oral theophylline in the prevention of CN. Methods. We randomized into two groups 70 patients with diabetes mellitus who were undergoing coronary angiography (CAG) with high‐osmolar contrast media. Group I (n=35) underwent routine CAG, and group II (n=35) received oral theophylline 200 mg b.d. 24 h before and for 48 h after CAG. Serum Na+, K+, blood urea nitrogen (BUN), creatinine, osmolality, glomerular filtration rate (GFR) and urinalysis were performed before and after CAG. The 99mTc‐DTPA‐clearance method was used to assess GFR. Results. Following angiography, patients in the control group showed a significant rise in serum creatinine (1.19±0.23 vs 1.44±0.32 mg/dl, P=0.003) and BUN (13.95±2.61 vs 17.55±3.9 mg/dl, P=0.01) along with a fall in GFR (85.4±14.7 vs 66.85±14.8 ml/min, P=0.008). The mean percentage fall in GFR was 35.8%. There was no significant change in serum creatinine (1.16±0.18 vs 1.24±0.21 mg/dl), BUN (12.8±3.36 vs 14.8±2.5 mg/dl) and GFR (86.8±15.8 vs 80.3±16.0 ml/min) in those receiving theophylline. No patient in the theophylline group had a &gt;25% rise in serum creatinine, compared with 7/35 in the control group (P=0.017). In the control group, 11/35 (31%) developed CN, as demonstrated by a ⩾25% fall in GFR, while only one patient in the theophylline group had a fall in GFR (P=0.004). None of the pre‐angiographic variables could predict the development of CN. Conclusions. Following the use of high‐osmolar contrast media for routine CAG, CN may develop in 31% of diabetic patients. Patients who received prophylactic oral theophylline had a significantly lower risk of CN than those who did not.</abstract><cop>England</cop><pub>Oxford University Press</pub><pmid>12401850</pmid><doi>10.1093/ndt/17.11.1936</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record>
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identifier ISSN: 0931-0509
ispartof Nephrology, dialysis, transplantation, 2002-11, Vol.17 (11), p.1936-1941
issn 0931-0509
1460-2385
1460-2385
language eng
recordid cdi_crossref_primary_10_1093_ndt_17_11_1936
source Oxford Journals Online
subjects acute renal failure
Administration, Oral
Adult
Aged
angiography
Blood Urea Nitrogen
cardiac catheterization
Case-Control Studies
Contrast Media - adverse effects
Coronary Angiography
Creatinine - blood
Diabetes Mellitus - diagnostic imaging
Diatrizoate Meglumine - adverse effects
Glomerular Filtration Rate - drug effects
Humans
Incidence
Kidney Diseases - chemically induced
Kidney Diseases - epidemiology
Kidney Diseases - prevention & control
Middle Aged
radiocontrast‐induced nephropathy
renal haemodynamics
theophylline
Theophylline - administration & dosage
title The role of theophylline in contrast‐induced nephropathy: a case‐control study
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