The preventive effects of different doses of atorvastatin on contrast‐induced acute kidney injury after CT perfusion

Abstract

Background: Contrast-induced acute kidney injury (CI-AKI) is a severe complication among patients receiving intravascular contrast media. The purpose of this study was to investigate the preventive effects of pretreatment of atorvastatin at intensive doses on CI-AKI after computed tomography (CT) perfusion. Methods:The levels of serum creatinine (SCR), blood urea nitrogen (BUN), Cystatin C (CysC), estimated glomerular filtration rate (eGFR), high-sensitivity C-reactive protein (hs-CRP), and interleukin-6 (IL-6) in patients were compared between the observation group receiving 40 mg/kg atorvastatin and the control group receiving 20 mg/ kg atorvastatin before and 72 h after CT examination. In addition, the incidence of CI-AKI was recorded.Results: Compared with the control group, the incidence of renal injury in the observation group was significantly reduced, from 8% to 2% (χ 2 = 6.62, p = 0.010). In addition, there was no notable difference in the levels of Scr, BUN, CysC, hs-CRP, and IL-6 before CT examination between two groups (p > 0.05). The levels of SCR, BUN, CysC, hs-CRP, and IL-6 were increased, while the levels of eGFR were decreased in the control group at 72 h after CT examination (p < 0.05). At 72 h after CT enhancement, the levels of BUN, CysC, and hs-CRP were prominently increased in the observation group (p < 0.05), while SCR, eGFR, and IL-6 did not change (p > 0.05). Compared with the control group, the levels of SCR, BUN, CysC, eGFR, hs-CRP, and IL-6 in the observation group were significantly decreased at 72 h after CT examination (p < 0.05). Conclusion:Intensive dose of atorvastatin pretreatment can prevent CI-AKI undergoing CT perfusion through lowering inflammation as well as renal function indexes SCR, CysC, BUN, and eGFR.

Biomarkers in Contrast-Induced Acute Kidney Injury: Towards A New Perspective

“…It was found that the sensitivity of CysC for diagnosing renal insufficiency was 82.8%, while that of Scr was only 68.2%, thus CysC is easier to detect. Therefore, as a marker of kidney function, CysC is more ideal than Scr [ 52 , 53 ]. Finally, a recent publication stated that sCysC at 24 h was the best biomarker for CIN diagnosis, while baseline levels of other common biomarkers were the best predictors of prognosis [ 54 ].…”

Combination of different drugs can enhance prevention of CIAKI through inhibition of endoplasmic reticulum stress-induced apoptotic pathway

“…The protective effect of atorvastatin on CIAKI depends on the dose. [14][15] But high dose of statins have side effects such as myolysis and liver damage, so we need to combine some drug with atorvastatin to prevent CIAKI. Both clinical studies [16][17][18][19][20] and animal experiments [21][22] have demonstrated that probucol or alprostadil can reduce renal damage by contrast agents and reduce the incidence of CIAKI.…”

The effects of atorvastatin on contrast-induced acute kidney injury; a systematic review and meta-analysis on clinical trials

“…However, it is a costly procedure, which poses an increased economic burden on patients and reduces their quality of life. Thus, CI-AKI prevention finds profound significance (4).…”