The protectif effect of calcium channel blockers after coroner arther angiogrophy

Introduction and Purpose: Today, with the development of medicine, the use of contrast in imaging and treatment methods is increasing rapidly. Among the acute kidney injury in the hospital, between 10% and 12% are found in the first three. One of the most important mechanisms in the pathogenesis of contrast induced nephropathy is ischemia that occurs in the kidneys. As a result, free oxygen radicals are increasing and the resulting oxidative stress causes ischemic and nephrotoxic damage. Contrast İnduced nephropathy increases life-threatening complications such as sepsis, bleeding, respiratory failure, and prolongs hospital stay leading to increased hospital costs. The prevention and treatment of a complication that is so important is very important in terms of physician, patient and country economy. With the contrast nephropathy prophylaxis the economical damage can be avoided. Renal failure secondary to contrast exposure can be avoided by methods such as avoidance of unnecessary investigations, saline infusion, acetylcysteine, CCB, ACEI. Our aim in this study was to retrospectively evaluate the outcome of use of CCB before and after contrast exposure, whose efficacy in the prophylaxis of contrast nephropathy is still unclear with many trials. Material and Method: This study was performed between January 2014 and June 2016 in Afyon Kocatepe University Faculty of Medicine, Department of Cardiology, in which coronary angiography was performed and dihydropyridine (amlodipine 10 mg), nondihidropyridine (diltiazem 60 mg) Eighty patients using ACEI were included. Patient information was obtained by retrospective screening of patient files. Patients were included in the study if their registries were sufficient. Individuals under the age of 18 and above 80 were not included in the study. Patients not undergoing coronary angiography, monotherapy in the form of dihydropyridine, nondihid-ropridine, and ACEI were excluded. Patients who did not take Urea, Cr, BUN and inadequate files were excluded within 3-15 days. Findings: When the demographic data of the patients studied were examined, the number of women in the group using ACEI was very low while the group of patients using CCB was similar in gender distribution. When the age distribution of the groups was evaluated, the group using CCB had a significantly older patient population than the group using ACEI. BMI, diastolic blood pressure distribution were smilar, but lower in the systolic blood pressure group using ACEI. Smoking rates and co-morbidities were similar between the two groups. When the laboratory data were examined, the potassium and phosphorus levels of the group using CCB were significantly higher than the group using ACEI. There was no significant difference between the other laboratory-tubal findings (including Cr, BUN, Urea, GFR). Increase in creatinine by 25% was considered as contrast nephropathy. The CCB use group included older patient populations. For this reason, it is expected that the risk of developing contrast induced nephropathy is higher. Nonetheless, the rates of contrast induced nephropathy were similar in the group using CCB and in the group using ACEI. The group using CCB was compared as the group using dihydropyridine and nondihydropidine. The development rates of contrast induced nephropathy were again similar. Conclusion: As a result; There are also studies that show that drugs in the CCB group may reduce the risk of developing contrast induced nephropathy and that the CCB group of drugs that support our data in the literature may reduce the risk of developing contrast induced nephropathy. Studies in which the CCB group drugs prevent the development of contrast induced nephropathy may provide that these group of drugs are especially preferred for patients receiving contrast media. However, our study suggests that there is no difference in the development of contrast induced nephropathy between the drug group and patients using ACEI. There is a need for comprehensive prospective studies that examine the effects of drugs in the CCB on the development of contrast induced nephropathy.