Effect of different hydration intensities combined with diuretics therapy on the renal function in high-risk patients after emergency percutaneous coronary intervention

LIANG Baixue; LI Mengguang; LI Yan

doi:10.3969/j.issn.1002-7386.2025.12.020

Abstract：Objective To evaluate the protective effect of different hydration intensities combined with diuretics therapy on the contrast-induced nephropathy in high-risk patients after emergency percutaneous coronary intervention(PCI).Methods Using convenient sampling method,a total of 132 patients with high-risk contrast-induced nephropathy after emergency PCI from January 2020 to May 2023 were selected.They were randomly divided into the strengthening hydration+diuretics therapy group,routine hydration+diuretics therapy group,strengthening hydration group,and routine hydration group using the random number table method,with 33 cases in each group.Patients in the routine hydration group were given hydration therapy at 6h before and 6h after PCI via continuous intravenous infusions of normal saline at 1mL/kg/h.Those in the strengthening hydration group were given hydration therapy at 12h before and 6h after PCI via continuous intravenous infusions of normal saline at 1mL/kg/h.Injection of 20mg furosemide was additionally given to patients in the diuretics therapy groups based on the corresponding hydration regimen.Serum creatinine(Scr)before,and 24,48 and 72h after PCI,and estimated glomerular filtration rate(eGFR)were compared among the four groups.The patients were followed up for 12 months after surgery,and the adverse events were recorded.Results At 48h after PCI,Scr was significantly lower in the strengthening hydration+diuretics therapy group than the routine hydration group(P＜0.05).At 72h after PCI,Scr in the strengthening hydration+diuretics therapy group was significantly lower than the routine hydration+diuretics therapy group,strengthening hydration group and routine hydration group(P＜0.05).The eGFR was significantly higher in the strengthening hydration+diuretics therapy group than the routine hydration+diuretics therapy group,strengthening hydration group and routine hydration group(P＜0.05).Patients were followed up for 12 months,and the risk of clinical adverse events in the strengthening hydration+diuretics therapy group,routine hydration+diuretics therapy group and routine hydration group was significantly lower than the strengthening hydration group(Log-rank 2=7.942,4.287,and 6.125,respectively;P＜0.05).Conclusion Strengthening hydration combined with diuretics therapy can effectively alleviate contrast-induced nephropathy in high-risk patients after emergency PCI,without increasing the risk of long-term adverse events.