Abstract
Background: Although intravenous saline is the accepted prophylactic measure for the prevention of contrast- induced acute kidney injury, the oral route could offer an equivalent, practical, and cost saving approach. A systematic review of randomized trials that compared oral versus intravenous volume expansion for the prevention of radiocontrast-induced nephropathy in patients receiving arterial contrast reported no significant difference in the risk of contrast induced acute kidney injury between the oral and intravenous arms. Most trials for contrast nephropathy prevention have been in the setting of arterial contrast such as with cardiac catheterization, and not with venous contrast, such as computed tomography. The aim of this paper is to describe the protocol of a pilot trial comparing the effect of oral salt and water versus intravenous saline on the prevention of Acute Kidney Injury following contrast-enhanced computed tomography. Methods: Our study is a pilot, single-centre parallel randomized controlled trial. To be included, participants must be at stage 4 of chronic kidney disease as defined by a glomerular filtration rate <30 mL/min/1.73 m2, aged greater than 18 years and to undergo an outpatient contrast-enhanced computer tomography of the chest or abdomen. A total 50 patients will be randomised to receive either oral salt and water or intravenous isotonic saline. The primary outcome is feasibility, including estimates of recruitment rate, adherence to intervention and completeness of follow-up to assist in planning the definitive trial. The secondary outcome is safety and includes adverse events with oral salt and water loading as compared to intravenous isotonic saline. Discussion: The results of this pilot trial will provide critical information to plan a definitive trial to test the efficacy of the route of volume loading regimens in prevention of acute kidney injury after contrast-enhanced CT scans. Trial registration: The trial is registered at the US National Institutes of Health (ClinicalTrials.gov) # NCT02084771.
| Original language | English (US) |
|---|---|
| Article number | 12 |
| Journal | Canadian Journal of Kidney Health and Disease |
| Volume | 2 |
| Issue number | 1 |
| DOIs | |
| State | Published - Apr 16 2015 |
| Externally published | Yes |
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Keywords
- Contrast-induced nephropathy
- Intravenous saline
- Oral Salt and Water
- Randomized controlled trial
ASJC Scopus subject areas
- Nephrology
Cite this
Oral salt and water versus intravenous saline for the prevention of acute kidney injury following contrast-enhanced computed tomography : Study protocol for a pilot randomized trial. / Swapnil, Hiremath; Knoll, Greg A.; Kayibanda, Jeanne Françoise; Fergusson, Dean; Chow, Benjamin J W; Shabana, Wael; Murphy, Erin; Ramsay, Tim; James, Matthew; White, Christine A.; Garg, Amit; Wald, Ron; Hoch, Jeffrey S; Akbari, Ayub.
In: Canadian Journal of Kidney Health and Disease, Vol. 2, No. 1, 12, 16.04.2015.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Oral salt and water versus intravenous saline for the prevention of acute kidney injury following contrast-enhanced computed tomography
T2 - Study protocol for a pilot randomized trial
AU - Swapnil, Hiremath
AU - Knoll, Greg A.
AU - Kayibanda, Jeanne Françoise
AU - Fergusson, Dean
AU - Chow, Benjamin J W
AU - Shabana, Wael
AU - Murphy, Erin
AU - Ramsay, Tim
AU - James, Matthew
AU - White, Christine A.
AU - Garg, Amit
AU - Wald, Ron
AU - Hoch, Jeffrey S
AU - Akbari, Ayub
PY - 2015/4/16
Y1 - 2015/4/16
N2 - Background: Although intravenous saline is the accepted prophylactic measure for the prevention of contrast- induced acute kidney injury, the oral route could offer an equivalent, practical, and cost saving approach. A systematic review of randomized trials that compared oral versus intravenous volume expansion for the prevention of radiocontrast-induced nephropathy in patients receiving arterial contrast reported no significant difference in the risk of contrast induced acute kidney injury between the oral and intravenous arms. Most trials for contrast nephropathy prevention have been in the setting of arterial contrast such as with cardiac catheterization, and not with venous contrast, such as computed tomography. The aim of this paper is to describe the protocol of a pilot trial comparing the effect of oral salt and water versus intravenous saline on the prevention of Acute Kidney Injury following contrast-enhanced computed tomography. Methods: Our study is a pilot, single-centre parallel randomized controlled trial. To be included, participants must be at stage 4 of chronic kidney disease as defined by a glomerular filtration rate <30 mL/min/1.73 m2, aged greater than 18 years and to undergo an outpatient contrast-enhanced computer tomography of the chest or abdomen. A total 50 patients will be randomised to receive either oral salt and water or intravenous isotonic saline. The primary outcome is feasibility, including estimates of recruitment rate, adherence to intervention and completeness of follow-up to assist in planning the definitive trial. The secondary outcome is safety and includes adverse events with oral salt and water loading as compared to intravenous isotonic saline. Discussion: The results of this pilot trial will provide critical information to plan a definitive trial to test the efficacy of the route of volume loading regimens in prevention of acute kidney injury after contrast-enhanced CT scans. Trial registration: The trial is registered at the US National Institutes of Health (ClinicalTrials.gov) # NCT02084771.
AB - Background: Although intravenous saline is the accepted prophylactic measure for the prevention of contrast- induced acute kidney injury, the oral route could offer an equivalent, practical, and cost saving approach. A systematic review of randomized trials that compared oral versus intravenous volume expansion for the prevention of radiocontrast-induced nephropathy in patients receiving arterial contrast reported no significant difference in the risk of contrast induced acute kidney injury between the oral and intravenous arms. Most trials for contrast nephropathy prevention have been in the setting of arterial contrast such as with cardiac catheterization, and not with venous contrast, such as computed tomography. The aim of this paper is to describe the protocol of a pilot trial comparing the effect of oral salt and water versus intravenous saline on the prevention of Acute Kidney Injury following contrast-enhanced computed tomography. Methods: Our study is a pilot, single-centre parallel randomized controlled trial. To be included, participants must be at stage 4 of chronic kidney disease as defined by a glomerular filtration rate <30 mL/min/1.73 m2, aged greater than 18 years and to undergo an outpatient contrast-enhanced computer tomography of the chest or abdomen. A total 50 patients will be randomised to receive either oral salt and water or intravenous isotonic saline. The primary outcome is feasibility, including estimates of recruitment rate, adherence to intervention and completeness of follow-up to assist in planning the definitive trial. The secondary outcome is safety and includes adverse events with oral salt and water loading as compared to intravenous isotonic saline. Discussion: The results of this pilot trial will provide critical information to plan a definitive trial to test the efficacy of the route of volume loading regimens in prevention of acute kidney injury after contrast-enhanced CT scans. Trial registration: The trial is registered at the US National Institutes of Health (ClinicalTrials.gov) # NCT02084771.
KW - Contrast-induced nephropathy
KW - Intravenous saline
KW - Oral Salt and Water
KW - Randomized controlled trial
UR - http://www.scopus.com/inward/record.url?scp=84998772470&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84998772470&partnerID=8YFLogxK
U2 - 10.1186/s40697-015-0048-7
DO - 10.1186/s40697-015-0048-7
M3 - Article
VL - 2
JO - Canadian Journal of Kidney Health and Disease
JF - Canadian Journal of Kidney Health and Disease
SN - 2054-3581
IS - 1
M1 - 12
ER -