{"id":"3fede62b2a4c","type":"article","url":"https://hartvaat.nl/2022/05/25/hydratie-ter-preventie-van-nierschade-na-primaire-pci-gerandomiseerde-trial/","title":"Hydratie ter preventie van nierschade na primaire PCI: gerandomiseerde trial","title_en":"Hydration for prevention of kidney injury after primary coronary intervention for acute myocardial infarction: a randomised clinical trial.","category":"hartfalen","category_label":"Hartfalen","professions":["cardioloog"],"tags":[],"journal":"Heart (British Cardiac Society)","doi":"10.1136/heartjnl-2021-319716","source_url":"https://doi.org/10.1136/heartjnl-2021-319716","authors":["Yong Liu","Ning Tan","Yong Huo","Shiqun Chen","Jin Liu","Yun-Dai Chen","Keng Wu","Guifu Wu","Kaihong Chen","Jianfeng Ye","Yan Liang","Xinwu Feng","Shaohong Dong","Qiming Wu","Xianhua Ye","Hesong Zeng","Minzhou Zhang","Min Dai","Chong-Yang Duan","Guoli Sun","Yibo He","Feier Song","Zhaodong Guo","Ping-Yan Chen","Junbo Ge","Ying Xian","Jiyan Chen"],"significance":5,"published":"2022-05-25","source_date":"2022-05-25","image":"","kennis":[],"congress":"","summary_en":"This randomized trial tested aggressive versus general hydration for preventing contrast-induced kidney injury after primary PCI for acute MI, evaluating a simple intervention for renal protection during emergent procedures.","created":"2026-07-03T10:29:46Z","updated":"2026-07-03T13:28:53Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Gerandomiseerde trial naar hydratie ter preventie van nierschade na primaire PCI bij acuut MI.","abstract_original":"OBJECTIVE: To evaluate the efficacy of aggressive hydration compared with general hydration for contrast-induced acute kidney injury (CI-AKI) prevention among patients with ST-elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (pPCI). METHODS: The Aggressive hydraTion in patients with STEMI undergoing pPCI to prevenT Contrast-Induced Acute Kidney Injury study is an open-label, randomised controlled study at 15 teaching hospitals in China. A total of 560 adult patients were randomly assigned (1:1) to receive aggressive hydration or general hydration treatment. Aggressive hydration group received preprocedural loading dose of 125/250 mL normal saline within 30 min, followed by postprocedural hydration performed for 4 hours under left ventricular end-diastolic pressure guidance and additional hydration until 24 hours after pPCI. General hydration group received ≤500 mL 0.9% saline at 1 mL/kg/hour for 6 hours after randomisation. The primary end point is CI-AKI, defined as a >25% or 0.5 mg/dL increased in serum creatinine from baseline during the first 48-72 hours after primary angioplasty. The safety end point is acute heart failure. RESULTS: From July 2014 to May 2018, 469 patients were enrolled in the final analysis. CI-AKI occurred less frequently in aggressive hydration group than in general hydration group (21.8% vs 31.1%; risk ratio (RR) 0.70, 95% CI 0.52 to 0.96). Acute heart failure did not significantly differ between the aggressive hydration group and the general hydration group (8.1% vs 6.4%, RR 1.13, 95% CI 0.66 to 2.44). Several subgroup analysis showed the better effect of aggressive hydration in CI-AKI prevention in male, renal insufficient and non-anterior myocardial infarction participants. CONCLUSIONS: Comparing with general hydration, the peri-operative aggressive hydration seems to be safe and effective in preventing CI-AKI among patients with STEMI undergoing pPCI."}