Use of Alpha-Lipoic Acid in Prevention of Contrast-Induced Nephropathy in Diabetic Patients

Figures & data

Table 1. Baseline clinical parameters, laboratory findings, and medications of the patients.

	Control group (n = 39)	ALA group (n = 39)	p
Gender	F: 16 (41%)	F: 15 (38.5%)	1.000
	M: 23 (59%)	M: 24 (61.5%)
Age	66.5 ± 9.6	64.3 ± 8.4	0.29
BMI (kg/m^2)	28.8 ± 3.7	29.1 ± 3.9	0.76
Smoking	10 (25.6%)	1 (2.6%)	0.002
Hypertension	35 (89.7%)	34 (87.2%)	1.0
Diabetes mellitus	Insulin: 13 (33.3%)	Insulin: 12 (30.8%)	1.0
	OAD: 26 (66.7%)	OAD: 27 (69.2%)
CAD hx	11 (28.2%)	24 (61.5%)	0.04
Detected CAD	26 (66.7%)	33 (84.6%)	0.11
Mehran risk score	5.59 ± 1.96	5.49 ± 1.73	0.54
PAD	1 (2.6%)	1 (2.6%)	1.0
HL	30 (76.9%)	24 (61.5%)	0.22
Laboratory findings
Hb (g/dL)	13.38 ± 1.57	13.64 ± 1.62	0.46
HbA1c (%)	7.07 ± 1.38	7.63 ± 1.42	0.08
BUN (mg/dL)	18.23 ± 4.87	18.43 ± 6.93	0.88
Creatinine (mg/dL)	0.89 ± 0.18	0.86 ± 0.18	0.49
Cr Cl (mL/dk/1.73 m^2)	88.87 ± 21.09	96.73 ± 23.91	0.13
NGAL(u) (ng/mL)	16.80 (3.60–37.00)	14.00 (5.50–24.70)	0.67
Cystatin C (ng/mL)	1109 (846–1526)	916 (727–1115)	0.036
Medications
ACEI	13 (33.3%)	11 (28.2%)	0.807
ARB	15 (38.5%)	12 (30.8%)	0.635
CCB	14 (35.9%)	13 (33.3%)	1.000
BB	23 59.0%)	21 (53.8%)	0.820
Statins	19 (48.7%)	25 (65.8%)	0.169
ASA	19 (48.7%)	29 (74.4%)	0.033
Warfarin	2 (5.1%)	3 (7.7%)	1.000
Furosemide	2 (5.1%)	5 (12.8%)	0.431
Thiazide	16 (41.0%)	8 (20.5%)	0.085
Spironolactone	1 (2.6%)	2 (5.1%)	1.000
Nitrate	3 (7.7%)	11 (28.2%)	0.018

Note: ALA, alpha-lipoic acid; F, female; M, male; BMI, body mass index; CAD hx, coronary artery disease history; PAD, peripherial arterial disease; HL, hyperlipidemia; Hb, hemoglobin; HbA1c, hemoglobin A1c; BUN, blood urea nitrogen; NGAL(s), neutrophil gelatinase-associated lipocalin serum, NGAL(u), neutrophil gelatinase-associated lipocalin urine; Cr Cl, creatinine clearence; ACEI, angiotensin converting enzyme inhibitor; ARB, angiotensin receptor blocker; CCB, calcium channel blocker; BB, beta-blocker; ASA, acetyl salicylic acid.

Table 2. Contrast medium and hydration amounts and CIN incidence between the groups.

	Control group (n = 39)	ALA group (n = 39)
Contrast (mL)	80.00 (60.00–120.00)	75.00 (50.00–100.00)
Contrast (mL/min)	1.17 (0.47–2.43)	1.01 (0.32–3.33)
Hydration (mL)	2862 ± 447	2636 ± 592
Urine (mL)	2509 ± 471	2305 ± 651
CIN (≥25% increase)	3 (7.7%)	3 (7.7%)
CIN (≥0.5 mg/dL increase)	2 (5.1%)	0 (0%)

Notes: ALA, alpha-lipoic acid.

p > 0.05 for all comparisons.

Table 3. Comparison of changes in serum cystatin C and urinary NGAL levels between the groups.

	Control group (n = 39)	ALA group (n = 39)	p
Sis C (ng/mL) (B)	1109 (846–1526)	916 (727–1115)	0.25
	IQR:680	IQR:388
Sis C (ng/mL) (24)	1013 (821–1633)	912 (756–1305)
	IQR:812	IQR:549
NGAL (ng/mL) (B)	16.80 (3.60–37.00)	14.00 (5.50–24.7)	0.32
	IQR:33.4	IQR:19.2
NGAL (ng/mL) (4)	14.10 (1.60–21.10)	14.50 (4.40–20.00)
	IQR:19.5	IQR:15.6

Notes: ALA, alpha-lipoic acid; NGAL, neutrophil gelatinase-associated lipocalin; Cys, cystatin C; B, baseline; 24, 24th hour; 4, 4th hour.

*p-Value of variance analysis in repeated measures.

Figure 1. Changes in urinary NGAL levels in control and treatment groups.

Figure 2. Changes in serum cystatine levels in control and treatment groups.