Edaravone in contrast-induced acute kidney injury prophelaxis

The aim – to evaluate the effectiveness of edaravon in preventing the development of contrast-induced acute kidney injury. Materials and methods. We have conducted a multicenter open prospective randomized controlled study to evaluate the efficacy of edaravone in preventing contrast-induced acute kidney injury in patients with chronic kidney disease (CKD) 3b–4 stages. The study included 2 groups of patients aged 46 to 68 (55±3): group A (n=16) with CKD stage 3b or 4 (еstimated glomerular filtration rate (formula СКD-EPI) 32±4 ml/min) that received intravenous edaravone 30 mg bid on 0, 1, 2 day of contrast media infusion and control group B (n=20) with CKD stage 3b or 4 (еstimated glomerular filtration rate 33±3 ml/min) with no edaravone intervention during CT coronarography. Patients of both groups received intravenous hydration with 0.9 % sodium before CT. Primary endpoint: contrast-induced acute kidney injury onset in 48 hours after contrast media infusion and need for RRT. Secondary endpoint: serum potassium level above 5.5 mmol/l. Results. Contrast-induced acute kidney injury onset was obtained in 4 patients of group A and 12 patients of group B (p≤0.05, RR 0.417, RRR 0.583, RD 0.350, NNT 2.857). The results shows statistical significance both of endpoints which demonstrates the promising possibilities for contrast-induced acute kidney injury prophylaxis with edaravone in CKD 3b–4. Individual data analyses shows that edaravone was more effective in CKD 3b (3 cases of contrast-induced acute kidney injury of 10) instead of CKD 4 (1 of 2). Conclusions. Edaravone is promising solution for contrast-induced acute kidney injury prevention in patients with CKD 3b–4 who urgently undergo CT coronarography.