Does Prophylactic Treatment with Felodipine, a Calcium Antagonist, Prevent Low-Osmolar Contrast-Induced Renal Dysfunction in Hydrated Diabetic and Nondiabetic Patients with Normal or Moderately Reduced Renal Function?

Abstract

Twenty-seven patients (15 diabetics and 12 non-diabetics) with normal to moderately reduced renal function underwent femoral angiography with a low-osmolar contrast agent, iohexol (Omnipaque®), under perexaminatory hydration. Fourteen patients were randomised to pretreatment with oral felodipine extended release (Plendil®) 10 mg and 13 patients to placebo 3-4 h before angiography. GFR measured with [⁵¹Cr] EDTA-clearance decreased 24 hours after the angiography in the felodipine group from GFR 52.5 ± 18.6 (mean ± SD) to 46.2 ± 16.5 ml/min (p < 0.01) and in the placebo group from 70.6 ± 18.6 to 62.6 ± 26.4 ml/min (p < 0.01). Serum creatinine increased significantly in the felodipine group from 128 ± 61 to 139 ± 67 μmol/l (p < 0.05) but not in the placebo group (122 ± 54 to 125 ± 51 μmol/l (ns)). The values of serum creatinine returned to baseline levels 7 days after angiography. During hydration there was only a slight reduction of GFR after angiography with iohexol. Thus, felodipine had no major effect on GFR after iohexol but, as baseline GFR tended to be lower in the felodipine pre-treated patients, it might have had some renoprotective effect in patients with more advanced renal failure.

Key words:

• hydration
• felodipine
• angiography
• iohexol
• nephrotoxicity