Preventive effect of sodium bicarbonate combined Vit C on contrast-induced nephropathy in patients with early diabetic nephropathy undergoing PCI / 心血管康复医学杂志

ABSTRACT

Objective:To explore preventive effect of sodium bicarbonate combined Vit C on contrast-induced nephropathy (CIN) in patients with early diabetic nephropathy (DN) undergoing percutaneous coronary intervention (PCI).Methods: A total of 420 patients with coronary heart disease complicated early DN treated in our department from Sep 2014 to Jul 2016 were selected ,randomly and equally divided into routine PCI group and combined treatment group (received sodium bicarbonate combined Vit C based on routine PCI group ) . Levels of serum creatinine (SCr ) ,glomerular filtration rate (GFR) ,creatinine clearance rate (Ccr) and blood urea nitrogen (BUN) after contrast use and incidence rate of CIN were measured ,recorded and compared between two groups ,and independent risk factors for CIN were analyzed .Results: After contrast use ,compared with routine PCI group ,there were significant reductions in levels of SCr [(110-32 ± 12-35) μmol／L vs.(100-30 ± 9-73) μmol／L] and BUN [ (11-23 ± 2-43) mmol／L vs.(7-16 ± 3-14) mmol／L] ,and significant rise in GFR [ (30-67 ± 9-56) ml·min－1 ·1-73m－2 vs.(37-26 ± 7-69) ml·min－1 ·1-73m－2 ] and Ccr [ (62-31 ± 19-73) ml／min vs.(68-07 ± 21-48) ml／min] in combined treatment group , P＜0-01 all ; percentages of SCr rise ≥44-2μmol／L (6-7% vs.1-9%) and SCr increase ≥25% (9-0% vs.2-9%) significantly reduced in combined treatment group , P＝0-016 ,0-007- Multi-factor Logistic regression analysis indicated that contrast dose was independent risk factor for CIN in DN patients (OR＝1-688 , P＝0-001) , while use of sodium bicarbonate combined Vit C was its independent protective factor (OR＝0-693 , P＝0-021).Conclusion: For patients with early DN undergoing PCI ,sodium bicarbonate combined Vit C can significantly reduce incidence rate of CIN ,effectively protect kidney function ,which is worth extending .