Effectiveness of edaravone in preventing contrast-induced nephropathy in high-risk patients undergoing coronary angiography: A randomized, double-blind trial

Pharmacol Res Perspect. 2024 Aug;12(4):e1228. doi: 10.1002/prp2.1228.

Abstract

Contrast-induced nephropathy (CIN) is a serious complication that occurs subsequent to the administration of contrast media for therapeutic angiographic interventions. As of present, no effective therapy exists to prevent its occurrence. This single-center double-blind randomized controlled trial aimed to evaluate the effect of edaravone, an antioxidant, in a group of high-risk patients undergoing coronary angiography. Ninety eligible patients with chronic kidney disease Stages 3-4 were randomly assigned to either the control group (n = 45) or the intervention group (n = 45). In the intervention group, one dosage of edaravone (60 mg) in 1 L of normal saline was infused via a peripheral vein 1 h prior to femoral artery-directed coronary angiography. Patients in the control group received an equal amount of infusion in their last hour before angiography. Both groups received intravenous hydration with 0.9% sodium 1 mL/kg/h starting 12 h before and continuing for 24 h after angiography. The primary outcome measure was the onset of CIN, defined as a 25% increase in serum creatinine levels 120 h after administration of contrast media. The occurrence of CIN was observed in 5.5% (n = 5) of the studied population: 2.2% of patients in the intervention group (n = 1) and 8.9% of controls (n = 4). However, this difference was not statistically significant. Administration of a single dosage of edaravone 1 h prior to infusion of contrast media led to a reduction in the incidence of CIN. Further investigations, employing larger sample sizes, are warranted to gain a comprehensive understanding of its efficacy.

Keywords: antioxidants; chronic kidney injury; contrast media; contrast‐induced‐acute kidney injury; edaravone.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Aged
  • Antipyrine / analogs & derivatives
  • Antipyrine / therapeutic use
  • Contrast Media* / adverse effects
  • Coronary Angiography* / adverse effects
  • Creatinine / blood
  • Double-Blind Method
  • Edaravone* / administration & dosage
  • Edaravone* / therapeutic use
  • Female
  • Free Radical Scavengers / administration & dosage
  • Free Radical Scavengers / therapeutic use
  • Humans
  • Kidney Diseases / chemically induced
  • Kidney Diseases / prevention & control
  • Male
  • Middle Aged
  • Treatment Outcome

Substances

  • Edaravone
  • Contrast Media
  • Free Radical Scavengers
  • Creatinine
  • Antipyrine