Introduction: Several drugs have been considered for the prevention of contrast medium-induced nephropathy. we will try to assess the reno-protective role of combination of use of both ascorbic acid and statin for patients undergoing urologic diagnostic CT with a contrast agent.
Methods: This 4-days, single-center, randomized, double-blind trial was for patients underwent elective contrast-enhanced computed tomography (CECT). Eligible patients were statin naïve patients, or not on statin treatment for at two weeks with normal renal function, planned for CECT.
Patients were divided into two groups: the first group received atorvastatin 80-mg loading dose given 24 hours once/daily before CECT with another 40-mg dose once/daily approximately 2 hours before the procedure and for another 2 days plus ascorbic acid 500mg once/daily in the same days of atorvastatin. The second group received two tablets of placebo once/daily before the procedure and for another 3 days.
The study outcomes were to detect the difference in serum creatinine and creatinine clearance (eGFR) (calculated using the 4-variable equation of Modification of Diet in Renal Disease) within 72 hours after administration of contrast agent, and to assess the incidence of contrast medium-induced nephropathy in both groups, defined as a relative increase in baseline serum creatinine values by =25% and/or an absolute increase of =0.5 mg/dL (=44.2µmol/L) within 472 hours after contrast administration.
Results: Both groups were comparable in baseline parameters. The baseline median (interquartile range [IQR]) of eGFR was 97.1 (80.7, 114.9) mL/min and 94.6 (78.2, 120.7) mL/min in placebo and Statin/Ascorbic acid group, respectively (p=0.66). The final median (IQR) of eGFR was 95.2 (72.8, 108.1) mL/min and 88.6 (71.9, 111.0) mL/min in placebo and Statin/Ascorbic acid group, respectively (p=0.48) (Table 2). However, the N(%) incidence of contrast medium-induced nephropathy occurred in 11 (9.8) and 3 (3) in placebo and Statin/Ascorbic acid group, respectively (p= 0.04).
Conclusions: Although the use of Statin/Ascorbic acid to prevent the contrast medium-induced nephropathy did not statistically improve the eGFR, it can decrease the incidence of the contrast medium-induced nephropathy, compared to the placebo.
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