Short-term rosuvastatin therapy for prevention of contrast-induced acute kidney injury in patients with diabetes and chronic kidney disease.

Abstract

OBJECTIVES:

This study sought to evaluate the safety and efficacy of rosuvastatin in preventing contrast-induced acute kidney injury (CI-AKI) in patients with diabetes mellitus (DM) and chronic kidney disease (CKD).

BACKGROUND:

CI-AKI is an important complication after contrast medium injection. While small studies have shown positive results with statin therapy, the role of statin therapy in prevention of CI-AKI remains unknown.

METHODS:

We randomized 2,998 patients with type 2 DM and concomitant CKD who were undergoing coronary/peripheral arterial angiography with or without percutaneous intervention to receive rosuvastatin, 10 mg/day (n = 1,498), for 5 days (2 days before, and 3 days after procedure) or standard-of-care (n = 1,500). Patients' renal function was assessed at baseline, 48 h, and 72 h after exposure to contrast medium. The primary endpoint of the study was the development of CI-AKI, which was defined as an increase in serum creatinine concentration ≥0.5 mg/dl (44.2 μmol/l) or 0.25% above baseline at 72 h after exposure to contrast medium.

RESULTS:

Patients randomized to the rosuvastatin group had a significantly lower incidence of CI-AKI than controls (2.3% vs. 3.9%, respectively; p = 0.01). During 30 days' follow-up, the rate of worsening heart failure was significantly lower in the patients treated with rosuvastatin than that in the control group (2.6% vs. 4.3%, respectively; p = 0.02).

CONCLUSIONS:

Rosuvastatin significantly reduced the risk of CI-AKI in patients with DM and CKD undergoing arterial contrast medium injection. (Rosuvastatin Prevent Contrast Induced Acute Kidney Injury in Patients With Diabetes [TRACK-D]; NCT00786136).

• Authors: Yaling Han, Guoying Zhu, Lixian Han, Fengxia Hou, Weijian Huang, Huiliang Liu, Jihong Gan, Tiemin Jiang, Xiaoyan Li, Wei Wang, Shifang Ding, Shaobin Jia, Weifeng Shen, Dongmei Wang, Ling Sun, Jian Qiu, Xiaozeng Wang, Yi Li, Jie Deng, Jing Li, Kai Xu, Bo Xu, Roxana Mehran, Yong Huo
• Journal: Journal of the American College of Cardiology (J Am Coll Cardiol) 2014 Jan 7-14 Vol. 63 Issue 1 Pg. 62-70 ISSN: 1558-3597 [Electronic] United States
• PMID: 24076297 (Publication Type: Comparative Study, Journal Article, Randomized Controlled Trial)
• Copyright: Copyright © 2014 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

Chemical References

• Contrast Media
• Fluorobenzenes
• Hydroxymethylglutaryl-CoA Reductase Inhibitors
• Pyrimidines
• Sulfonamides
• Rosuvastatin Calcium

Topics

• Acute Kidney Injury (chemically induced, prevention & control)
• Angiography (adverse effects, methods)
• Contrast Media (adverse effects)
• Diabetes Mellitus, Type 2 (complications, diagnostic imaging)
• Dose-Response Relationship, Drug
• Female
• Fluorobenzenes (administration & dosage, therapeutic use)
• Follow-Up Studies
• Humans
• Hydroxymethylglutaryl-CoA Reductase Inhibitors (administration & dosage, therapeutic use)
• Male
• Middle Aged
• Prospective Studies
• Pyrimidines (administration & dosage, therapeutic use)
• Renal Insufficiency, Chronic (complications, diagnostic imaging)
• Rosuvastatin Calcium
• Sulfonamides (administration & dosage, therapeutic use)
• Time Factors
• Treatment Outcome