Article ; Online: Iloprost as an acute kidney injury-triggering agent in severely atherosclerotic patients.
Cardiovascular journal of Africa
2016 Volume 27, Issue 3, Page(s) 128–133
Abstract: Background: Iloprost, a stable prostacyclin analog, is used as a rescue therapy for severe peripheral arterial disease (PAD). It has systemic vasodilatory and anti-aggregant effects, with severe vasodilatation potentially causing organ ischaemia when ... ...
| Abstract | Background: Iloprost, a stable prostacyclin analog, is used as a rescue therapy for severe peripheral arterial disease (PAD). It has systemic vasodilatory and anti-aggregant effects, with severe vasodilatation potentially causing organ ischaemia when severe atherosclerosis is the underlying cause. In this study, we retrospectively analysed renal outcomes after iloprost infusion therapy in 86 patients. Methods: Eighty-six patients with PAD who received iloprost infusion therapy were retrospectively analysed. Clinical and biochemical parameters were recorded before (initial, Cr1), during (third day, Cr2), and after (14th day following the termination of infusion therapy, Cr3) treatment. Acute kidney injury (AKI) was defined according to KDIGO guidelines as a ≥ 0.3 mg/dl (26.52 µmol/l) increase in creatinine levels from baseline within 48 hours. Results: Cr2 (1.46 ± 0.1 mg/dl) (129.06 ± 8.84 µmol/l) and Cr3 (1.53 ± 0.12 mg/dl) (135.25 ± 10.61 µmol/l) creatinine levels were significantly higher compared to the initial value (1.15 ± 0.6 mg/dl) (101.66 ± 53.04 µmol/l). AKI was observed in 36 patients (41.86%) on the third day of iloprost infusion. Logistic regression analysis revealed smoking and not using acetylsalicylic acid as primary predictors (p = 0.02 and p = 0.008, respectively) of AKI during iloprost treatment. On the third infusion day, patients' urinary output significantly increased (1813.30 ± 1123.46 vs 1545.17 ± 873.00 cm Conclusion: While iloprost treatment is effective in patients with PAD who are not suitable for surgery, severe systemic vasodilatation can cause renal ischaemia, resulting in nonoliguric AKI. Smoking, no acetylsalicylic acid use, and lower diastolic blood pressure are the clinical risk factors for AKI during iloprost treatment. |
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| MeSH term(s) | Acute Kidney Injury/blood ; Acute Kidney Injury/chemically induced ; Acute Kidney Injury/diagnosis ; Acute Kidney Injury/mortality ; Aged ; Aged, 80 and over ; Arterial Pressure ; Aspirin/therapeutic use ; Atherosclerosis/diagnostic imaging ; Atherosclerosis/drug therapy ; Atherosclerosis/mortality ; Atherosclerosis/physiopathology ; Biomarkers/blood ; Chi-Square Distribution ; Creatinine/blood ; Female ; Humans ; Iloprost/administration & dosage ; Iloprost/adverse effects ; Infusions, Intravenous ; Kaplan-Meier Estimate ; Logistic Models ; Male ; Middle Aged ; Platelet Aggregation Inhibitors/administration & dosage ; Platelet Aggregation Inhibitors/adverse effects ; Protective Factors ; Retrospective Studies ; Risk Assessment ; Risk Factors ; Severity of Illness Index ; Smoking/adverse effects ; Time Factors ; Treatment Outcome ; Up-Regulation ; Vasodilator Agents/administration & dosage ; Vasodilator Agents/adverse effects | |||||
| Chemical Substances | Biomarkers ; Platelet Aggregation Inhibitors ; Vasodilator Agents ; Creatinine (AYI8EX34EU) ; Iloprost (JED5K35YGL) ; Aspirin (R16CO5Y76E) | |||||
| Language | English | |||||
| Publishing date | 2016-05 | |||||
| Publishing country | South Africa | |||||
| Document type | Journal Article | |||||
| ZDB-ID | 2383233-2 | |||||
| ISSN | 1680-0745 ; 1996-3467 ; 1015-9657 ; 1995-1892 | |||||
| ISSN (online) | 1680-0745 ; 1996-3467 | |||||
| ISSN | 1015-9657 ; 1995-1892 | |||||
| DOI | 10.5830/CVJA-2015-051 | |||||
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| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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