DOES PROPHYLACTIC TREATMENT WITH FELODIPINE, A CALCIUM-ANTAGONIST, PREVENT LOW-OSMOLAR CONTRAST-INDUCED RENAL DYSFUNCTION IN HYDRATED DIABETIC AND NONDIABETIC PATIENTS WITH NORMAL OR MODERATELY REDUCED RENAL-FUNCTION

Twenty-seven patients (15 diabetics and 12 non-diabetics) with normal to moderately reduced renal function underwent femoral angiography wit h a low-osmolar contrast agent, iohexol (Omnipaque(R)), under perexami natory hydration. Fourteen patients were randomised to pretreatment wi th oral felodipine extended release (Plendil(R)) 10 mg and 13 patients to placebo 3-4 h before angiography. GFR measured with [Cr-51] EDTA-c learance decreased 24 hours after the angiography in the felodipine gr oup from GFR 52.5 +/- 18.6 (mean +/- SD) to 46.2 +/- 16.5 ml/min (p < 0.01) and in the placebo group from 70.6 +/- 18.6 to 62.6 +/- 26.4 ml/ min (p < 0.01). Serum creatinine increased significantly in the felodi pine group from 128 +/- 61 to 139 +/- 67 mu mol/l (p < 0.05) but not i n the placebo group (122 +/- 54 to 125 +/- 51 mu mol/l (ns)). The valu es of serum creatinine returned to baseline levels 7 days after angiog raphy. During hydration there was only a slight reduction of GFR after angiography with iohexol. Thus, felodipine had no major effect on GFR after iohexol but, as baseline GFR tended to be lower in the felodipi ne pre-treated patients, it might have had some renoprotective effect in patients with more advanced renal failure.