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Efficacy and Safety of a Balanced Salt Solution Versus a 0.9% Saline Infusion for the Prevention of Contrast-Induced Acute Kidney Injury After Contrast-Enhanced Computed Tomography

 Sehoon Park  ;  Dong Ki Kim  ;  Hee-Yeon Jung  ;  Chan-Duck Kim  ;  Jang-Hee Cho  ;  Ran-Hui Cha  ;  Jong Cheol Jeong  ;  Sejoong Kim  ;  Hyung-Jong Kim  ;  Tae Hyun Ban  ;  Byung Ha Chung  ;  Jung Pyo Lee  ;  Jung Tak Park  ;  Seung Hyeok Han  ;  Tae-Hyun Yoo  ;  Dong-Ryeol Ryu  ;  Sung Jin Moon  ;  Jung Eun Lee  ;  Wooseong Huh  ;  Ea Wha Kang  ;  Tae Ik Chang  ;  Kwon Wook Joo 
 KIDNEY MEDICINE, Vol.2(2) : 189-195, 2020-03 
Journal Title
Issue Date
acute kidney injury ; acute renal failure ; balanced salt solution ; computed tomography ; Contrast-induced acute kidney injury ; fluid ; saline
Rationale & Objective: We aimed to elucidate whether a balanced salt solution decreases the occurrence of contrast-induced acute kidney injury (CI-AKI) after contrast-enhanced computed tomography (CE-CT) as compared to 0.9% saline solution. Study Design: A randomized clinical trial. Setting & Participants: The study was performed in 14 tertiary hospitals in South Korea. Patients with estimated glomerular filtration rates (eGFRs) < 45 or <60 mL/min/1.73 m2 and additional risk factors (age ≥ 60 years or diabetes) who were undergoing scheduled CE-CT were included from December 2016 to December 2018. Intervention: An open-label intervention was performed. The study group received a balanced salt solution and the control group received 0.9% saline solution as prophylactic fluids for CE-CT. Outcomes: The primary outcome was CI-AKI, defined by creatinine level elevation ≥ 0.5 mg/dL or 25% from baseline within 48 to 72 hours after CE-CT. Secondary outcomes included AKI defined based on the KDIGO (Kidney Disease: Improving Global Outcomes) guideline, eGFR changes, death, or requiring dialysis within 6 months after CE-CT. Results: 493 patients received the study fluids. The control and study groups included 251 and 242 patients, respectively. The occurrence of CI-AKI in the study (10 [4.2%]) and control (17 [6.8%]) groups was not significantly different (P = 0.27). No significant difference was present for the secondary outcomes; AKI by the KDIGO definition (study: 19 [7.9%], control: 27 [10.8%]; P = 0.33), death/dialysis (study: 11 [4.7%], control: 9 [3.7%]; P = 0.74), and eGFR changes (study: 0.1 ± 0.2 mg/dL, control: 0.3 ± 2.8 mg/dL; P = 0.69). Limitations: This study failed to meet target enrollment. Conclusions: The risk for CI-AKI was similar after administration of a balanced salt solution and after use of 0.9% saline solution during CE-CT in higher-risk patients. Funding: This study was funded by CJ Healthcare (CS2015_0046). Trial Registration: Registered at ClinicalTrials.gov with study number NCT02799368. © 2020 The Authors
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Park, Jung Tak(박정탁) ORCID logo https://orcid.org/0000-0002-2325-8982
Yoo, Tae Hyun(유태현) ORCID logo https://orcid.org/0000-0002-9183-4507
Han, Seung Hyeok(한승혁) ORCID logo https://orcid.org/0000-0001-7923-5635
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