Pharmacological Strategies to Prevent Contrast-Induced Acute Kidney Injury

Table 9

Clinical trials comparing theophylline with placebo and other agents for prophylaxis of contrast-induced AKI after angiography.

Authors	Year	Type of procedure and contrast media	Number of patients; Intervention versus control	Study protocol		Intravascular volume expansion and NAC protocol	CI-AKI definition	Mean GFR; Intervention versus control (mL/min/1.73 m^2)	Incidence of CI-AKI		RRT requirement; Intervention versus control (%)
				Intervention	Control				Intervention versus control (%)	𝑃 value
Huber et al. [107]	2002	CAG/PAG; Iomeprol	50 versus; 50	Theophylline 200 mg IV 30 minutes before	Placebo	ND	↑Cr ≥0.5/2 days	*Cr 2.07 versus; 1.92	4 versus; 16	0.042	ND
Huber et al. [108]	2003	CAG; Imeron	50 versus; 50	Theophylline 200 mg IV 30 minutes before	Placebo	ND	↑Cr ≥0.5/2 days	*Cr 1.65 versus; 1.72	4 versus; 20	0.0138	ND
Dussol et al. [33]	2006	Various procedures; Ioxaglate, iobitriodol and iopromide	80 versus; 76 versus 77 versus 79	Theophylline 5 mg/kg 1 hour before	(1) NaCl 0.1 g/kg po 2 days; (2) NSS 15 ml/kg IV 6 hours; (3) (2) NSS 15 mL/kg IV 6 hours and; Furosemide 3 mg/kg IV	ND	↑Cr ≥0.5/2 days	33 versus; 38 versus 33 versus 34	7.5 versus; 6.6 versus 5.2 versus 15.2	ND	0 versus; 0 versus 0 versus 0
Huber et al. [109]	2006	Various procedures; Imeron	51 versus; 50 versus 49	Theophylline 200 mg IV 30 minutes before	(1) NAC 600 mg IV bid; (2) Combination	According to underlying disease	↑Cr ≥0.5/2 days	*Cr 1.25 versus; 1.25 versus 1.28	2 versus; 12 versus 4	0.047; 0.53**	2.7
Baskurt et al. [110]	2009	CAG; Ioversol	72 versus; 72 versus 73	Theophylline200 mg +; NAC 600 mg po bid	(1) None; (2) NAC 600 mg po bid	NSS 1 mL/kg/h 12 hours before and after	↑Cr ≥0.5/2 days	*Cr 1.47 versus; 1.3 versus 1.39	0 versus; 6.9 versus 9.6	0.033	0 versus; 0
Kinbara et al. [111]	2010	CAG; Iopamidol	15 versus 15	Theophylline 250 mg IV 30 minutes before	(1) None; (2) NAC 704 mg po bid	NSS 1 mL/kg/h 30 minutes before and; 10 hours after	↑Cr ≥0.5/2 days	63.4 versus; 63.7 versus 62.4	0 versus; 26.7 versus 0	0.0109	0 versus; 0
Bilasy et al. [112]	2012	CAG; Iopamidol	30 versus; 30	Theophylline 200 mg in NSS 100 mL IV 30 minutes before and; NAC 600 mg po bid	Placebo and; NAC 600 mg po bid	NSS 1 mL/kg/h 12 hours before and after; (In case of CHF; NSS 0.5 mL/kg/h)	↑Cr ≥25%/3 days or; ↑Cr ≥0.5/3 days	58.6 versus; 61.8	0 versus; 20	0.01	ND
Abizaid et al. [101]	1999	CAG; Hexabrix	20 versus; 20 versus 20	Aminophylline IV 4 mg/kg then 0.4 mg/kg/h 2 hours before	(1) None; (2) Dopamine 2.5 mcg/kg/h 2 hours before	N/2 1 mL/kg/h 12 hours before and after	↑Cr≥ 25%/2 days	*Cr 1.9 versus; 2.3 versus 1.9	35 versus; 30 versus 50	0.60	5 versus; 0 versus 0

 *Mean GFR data is not available. Data is shown as mean serum creatinine in mg/dL.
** 𝑃 value of intervention group compare to combination group.
bid: twice daily; CAG: coronary angiography; CHF: congestive heart failure; CI-AKI: contrast-induced acute kidney injury; Cr: creatinine; g: gram; D5W: 5% dextrose solution; h: hour; IV: intravenous; kg: kilogram body weight; mg: milligram; mL: milliliter; NAC: N-acetylcysteine; ND: no data; NSS: normal saline solution; N/2: 0.45% NaCl; po: per oral route; q12h: every 12 hours; RRT: renal replacement therapy.