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Kidney Week

Abstract: SA-PO529

Randomized Controlled Trial of Omega 3 Fatty Acids to Reduce Contrast-Induced Nephropathy in CKD Patients Undergoing Coronary Angiography

Session Information

Category: Acute Kidney Injury

  • 102 AKI: Clinical, Outcomes, and Trials

Authors

  • Al-Rowaie, Fadel A., King Fahad Medical City, Riyadh, Saudi Arabia
  • Almatham, Khalid Ibrahim, King Fahad Medical City, Riyadh, Saudi Arabia
Background

Contrast-induced nephropathy (CIN) is a leading cause of acquired acute kidney injury and has been associated with prolonged hospitalization and adverse clinical outcomes. The results of studies investigating the effects of antioxidants on the prevention of CIN remain inconsistent.Omega 3 fatty acids have been shown to reduce inflammatory markers and oxidative stress, improve endothelial function, and reduce kidney dysfunction following reperfusion injury and chronic renal insufficiency in animal models.This pilot study aimed to determine the effects of omega 3 fatty acids on CIN prevention in patients with chronic kidney disease (CKD) undergoing coronary angiography

Methods

67 patients were assigned to the N-acetylcysteine (NAC) and 63 patients were assigned to the omega 3 fatty acids (omacor ®). Both drugs were administered orally twice per day on the day prior to and on the day of contrast administration, for a total of 2 days.The primary endpoint was the occurrence of CIN, defined as an increase in baseline serum creatinine levels of > 0.5 mg/dl (44 μmol/l) or > 25% increase in serum creatinine levels from baseline levels 48–72 h following contrast administration.The secondary endpoints were: the need for renal replacement therapy, death, and length of hospitalization after contrast administration

Results

Of the 130 CKD patients enrolled in this study,10 (7.7%) experienced an increase of at least 0.5 mg/dl (44 μmol/l) in serum creatinine levels 48 h after administration of the contrast agent, including 5 of the 67 patients in the NAC group (7.5%) and 5 of the 63 patients in the omega 3 fatty acids group (7.9%; P = 0.919). There were no significant differences in the need for renal replacement therapy or in the mortality rate between both groups

Conclusion

Short-term prophylactic omega 3 fatty acid treatment with hydration does not reduce CIN in CKD patients undergoing coronary angiography

Primary and secondary endpoints
OutcomeNAC (N=67)Omega 3 fatty acid ( N=63)P-value
Primary endpoint
Increase in creatinine > 44 μmol/l5 (7.5%)5 (7.9%)0.919
Increase in creatinine > 25%6 (9.1%)9 (14.3%)0.358
Secondary endpoints
renal replacement therapy2 (3.0%)6 (9.5%)0.121
death2 (3.0%)4 (6.3%)0.361
hospitalization(days)6.70 ± 8.736.16 ± 7.820.714
    
    

Funding

  • Government Support - Non-U.S.