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document
Determinants of serum creatinine trajectory in acute contrast nephropathy . The aim of this study was to describe the trajectory of creatinine ( Cr ) rise and its determinants after exposure to radiocontrast media . Included were 98 subjects who underwent cardiac catheterization and were randomized to forced diuresis with i.v . crystalloid , furosemide , mannitol ( if pulmonary capillary wedge pressure was < 20 mmHg ) , and low dose dopamine versus intravenous crystalloid and matching placebos . Baseline and postcatheterization serum Cr levels were analyzed in a longitudinal fashion , allowing for differences in the time between blood draws , to determine the different critical trajectories of serum Cr . The mean age , baseline serum Cr , and Cr clearance ( CrCl ) were 69.3 +/- 10.8 years , 2.5 +/- 0.9 mg/dL , and 31.4 +/- 12.1 mL/min , respectively . The clinically driven postprocedural observation time was 5.5 +/- 5.1 days ( range 19 hours and one Cr value to 25.7 days and 18 values ) . The mean maximum Cr was 3.3 +/- 1.4 , range 1.7-8.7 mg/dL ) . Longitudinal models support baseline Cr clearance predictions for the change in Cr at 24 hours , time as the determinant of Cr trajectory , and requisite monitoring . For any given individual , a rise in Cr of < or = 0.5 mg/dL in the first 24 hours after contrast exposure predicted a favorable outcome . Baseline renal function is the major determinant of the rate of rise , height , and duration of Cr trajectory after contrast exposure . Length of observation and frequency of laboratory measures can be anticipated from these models .
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Intervention_Pharmacological
diuresis with i.v . crystalloid , furosemide , mannitol ( if pulmonary capillary wedge pressure was < 20 mmHg ) ,
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Intervention_Pharmacological
low dose dopamine
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Intervention_Pharmacological
crystalloid
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Intervention_Control
matching placebos
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Outcome_Physical
creatinine ( Cr )
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Outcome_Physical
serum Cr levels
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Outcome_Physical
mean age
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Outcome_Physical
baseline serum Cr
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Outcome_Physical
Cr clearance ( CrCl )
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Outcome_Other
clinically driven postprocedural observation time
11200
Outcome_Physical
mean maximum Cr
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Outcome_Physical
Cr clearance
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Outcome_Physical
Cr
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Outcome_Physical
Baseline renal function
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Participant_Condition
nephropathy
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Participant_Condition
radiocontrast
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Participant_Sample-size
98
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Participant_Condition
cardiac catheterization
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Participant_Condition
baseline serum Cr
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Participant_Condition
Cr clearance
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Participant_Age
69.3 +/- 10.8 years ,