We are all aware of the high prevalence of CIN, and the limited utility of currently available agents to prevent it. This trial of 254 patients with baseline creatinine > 1.3 mg/dl undergoing coronary angiography randomized participants to ANP versus lactated ringers (LR) fluids (both for 4-6 hrs before and 48 hours after). The incidence of CIN (>25% or >0.5 mg/dl increase from baseline) occurred in 3% versus 12% of the ANP and LR group (p=0.02), respectively. In multivariate analysis, ANP significantly reduced the incidence of CIN (OR 0.24; p=0.02). If confirmed in larger studies, we may soon be able to add ANP to our preventive strategy arsenal (abstract)
Dr. Scheurer is a clinical hospitalist and the Medical Director of Quality and Safety at the Medical University of South Carolina in Charleston, South Carolina, and is Assistant Professor of Medicine. She is a graduate of the University of Tennessee College of Medicine, completed her residency at Duke University, and completed her Masters in Clinical Research at the Medical University of South Carolina. She also serves as the Web Editor and Physician Advisor for the Society of Hospital Medicine.