Há uma associação entre anti-inflamatórios não-esteroides e nefropatia induzida por contraste?

Abstract

Background: The association between the use of nonsteroidal anti-inflammatory drugs (NSAIDs) and acute or chronic renal failure is well documented, but evidence of such association between NSAIDs and Contrast-Induced Nephropathies (CIN) is not found in the indexed literature. Objective: To evaluate the possible association between NSAIDs and CIN. Methods: In a cohort study, through clinical interviews of patients that underwent cardiac catheterization, we analyzed the use of NSAIDs and its association with the development of CIN, through alterations in serum creatinine or glomerular filtration rate in 48 or 72 hours. Results: From July 2005 to July 2006, 236 patients were enrolled in the study, of which 29 were later excluded. The incidence of CIN was 10.37% (20 of 207) and 42% of the patients were using NSAIDs until the moment of the evaluation. There was no association between the use of NSAIDs and the development of CIN with OR of 1.293 95% CI (0.46-4.2). The study detected known risk factors for the development of CIN, such as diabetes with OR of 2.77 95%CI (1.05-7.47) and chronic renal failure with OR 3.48 95%CI (1.1-11.07). A protective action of saline solution hydrationis also suggested, with OR of 0.166 95%CI (0.03-0.92). Conclusion: Based on the data obtained, we conclude that there was no association between CIN and previous use of NSAIDs, at least with an OR higher then 2.85, which our sample detected.