P4303Short term benzbromarone treatment in patients with chronic kidney disease accompanied with hyperuricemia undergoing elective coronary intervention a prospective study

Abstract

Background: Contrast-induced nephropathy (CIN) is a common complication in percutaneous interventions especially in patients with impaired renal function. Recently, hyperuricemia is believed to be an independent risk factor of CIN. Purpose: The aim of the study was to evaluate the renal protective effects of urate lowing therapy (ULT) by benzbromarone in patients undergoing elective coronary angiography or intervention. Methods: We prospectively assessed the efficacy of benzbromarone in preventing CIN. 120 patients, with eGFR ranged from 20-60 accompanied with hyperuricemia, randomized into urate lowing therapy (ULT) group and control group according to the ratio of 1:2. Benzbromarone (50mg.bid.po), sodium bicarbonate (0.5g.tid.po) and hydration (1ml/kg/h N/saline for 12h pre- and post-contrast) were given 24h before administration of contrast media in ULT group (n=40). Control group received hydration only (n=80). Results: CIN occurred in 19 of 80 patients (23.8%) in the control group and 1 of 40 patients (2.5%) in the ULT group (p=0.001). In the ULT group, median eGFR increased significantly from 42.9±8.9 (ml/min1.73m2) to 47.1±11.8 (ml/min1.73m2) at 48h to 72h after contrast media administration (p=0.003 compared with the baseline). In the control group, median eGFR decreased non-significantly from 40.3±10.0 (ml/min1.73m2) to 35.8±13.6 (ml/min1.73m2) at 48h to 72h after contrast media administration (p=0.089, respectively). Multiple logistic regression analysis indicated that ULT by benzbromarone was linked with CIN after adjusting for potential confounding factors (RR=0.04, 95% CI, 0.00-0.61; p=0.021) compared with control group. Conclusions: Prophylactic use of benzbromarone and sodium bicarbonate, along with hydration, may protect against CIN in CKD patients with hyperuricemia undergoing coronary ang (Figure Presented).