Effect of Darbepoetin in Contrast-induced Nephropathy

Prevention of Contrast-Induced Nephropathy by Darbepoetin in Patients With Chronic Kidney Disease

The purpose of this study is to determine whether the drug that produce red blood cells is effective in the prevention of kidney dysfunction after coronary angiography in patients with chronic kidney disease.

Use of radiocontrast agent is inevitable in computed tomography or angiography. However, contrast agent can aggravate kidney function. Contrast-induced nephropathy (CIN) refers to the clinical situation where decreased kidney function after use of contrast. CIN is the 3rd most common cause of acute kidney injury in the hospitals. There are a lot of reports that death rate is increased in patients with CIN.

Erythropoietin is an agent that treat anemia. It also has been reported to have a tissue-protective effect in the animal experiments.

In this study, we hypothesized that erythropoietin can reduce the incidence of CIN in patients with chronic kidney disease undergoing coronary angiography.

Inclusion Criteria:

• age over 18 yr
• estimated glomerular filtration rate (GFR) < 60 ml/min/1.73m2

Exclusion Criteria:

• Chronic renal replacement therapy (hemodialysis, peritoneal dialysis, continuous renal replacement therapy)
• Pregnancy or lactation
• Use of contrast agent within 1 week
• Emergent CAG or PCI
• Not recovered from AKI(acute kidney injury)
• Use of nephrotoxic drugs within 48 hr
• Cardiogenic shock (SBP(systolic blood pressure) < 90 mmHg) or pulmonary edema
• Uncontrolled hypertension (SBP ≥ 200 mmHg or DBP(diastolic blood pressure) ≥ 130 mmHg)
• History of hypersensitivity to contrast agent
• Known allergy or hypersensitivity to EPO(erythropoietin)
• Use of EPO within 1 month
• Anemia (hemoglobin < 9 g/dL)
• Ventilatory care