Abstract 14936: Prevention of Contrast-induced Nephropathy by Inferior Vena Cava Ultrasonography-guided Hydration in Chronic Heart Failure Patients

Introduction: Contrast-induced nephropathy (CIN) is a common complication resulting from the administration of contrast media. This study was designed to determine whether inferior vena cava ultrasonography (IVCU)-guided hydration can reduce the risk of CIN in chronic heart failure patients undergoing coronary angiography or coronary angiography with percutaneous coronary intervention (PCI) than standard hydration. Methods: This prospective clinical trial enrolled 207 chronic heart failure patients from February 2016 to November 2017, who were randomly assigned to either IVCU-guided hydration group (n = 104) or the routine hydration group (n = 103). In the IVCU-guided group, the hydration infusion rate was set according to inferior vena cava diameter (IVC-D) determined by IVCU; while the control group received intravenous infusion of 0.9% saline at 0.5 ml/((kg·h)). Serum creatinine (SCr) was measured before and 48-72 hours after procedure. All patients were followed up for 18 months. The incidence of nephropathy and major adverse cardiovascular or cerebrovascular events (MACCE) were also compared between two groups. Results: Statistically significant difference between two groups regarding the occurrence of CIN were observed (12.5% vs. 29.1%, p = 0.003); The hydration volume of the IVCU-guided group is significantly higher than routine group (p<0.001). In addition, patients receiving IVCU-guided hydration had significantly lower risk of developing MACCE compared with patients in control group during 18 months follow-up (14.4% vs. 27.2%, p = 0.027). Conclusions: IVCU-guided hydration is superior to standard hydration in prevention of CIN and substantially reduce longtime composite major adverse events.