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)
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