Effects of Renin–Angiotensin–Aldosterone System Blockers and Renoprotective Regimens on Contrast-Induced Nephropathy

Abstract

We thank Dr Eyuboglu for the comments 1 related to our study. 2Current guidelines recommend preventive hydration with isotonic saline to be started approximately 12 hours before angiography and continued for at least 24 hours afterward to reduce the risk of contrast-induced nephropathy (CIN).3 Furthermore, infusion of sodium bicarbonate and N-acetylcysteine is not recommended. Another preventive recommendation is to start high-dose statin therapy before angiography.3 Following these recommendations, we started hydration with isotonic saline and administered highdose statins for our patients. The association between chronic use of renin-angiotensin-aldosterone system blockers and CIN is not well established; there is only 1 small observational study 4 on this issue, so we did not use this information in our study. 2As expected, the frequency of diabetes mellitus and hypertension was higher in the CIN group as expected and we included these variables in multivariate analysis with the platelet to lymphocyte ratio (PLR). In this analysis, PLR was still an independent predictor of CIN.In conclusion we demonstrated 2 that PLR (a readily available parameter) is a good predictor of CIN in acute coronary syndrome. Authors' NoteI have no commercial, financial, and other relationships in any way related to the subject of this article all that might create any potential conflict of interest. References1. Eyuboglu M. Effects of renin-angiotensin-aldosterone system blockers and renoprotective regimens on contrast-induced nephropathy. Angiology. 2015.