THE EFFECT OF PROPHYLACTIC NIFEDIPINE ON RENAL-FUNCTION IN PATIENTS ADMINISTERED CONTRAST-MEDIA

Study Objective. To determine if prophylaxis with nifedipine could dec rease the frequency of contrast medium-induced renal impairment. Desig n. Prospective, randomized clinical trial. Setting. A university-affil iated hospital. Patients. Patients undergoing scheduled radiologic exa minations involving infusion of contrast media. Interventions. Forty-t wo patients were randomized to receive nifedipine 10 mg orally 1 hour before the imaging procedure, and 43 to receive no treatment. Measurem ents and Main Results. Baseline serum creatinine levels were compared with maximum levels 24 and 48 hours after administration of contrast m edium. No statistically significant difference was seen in either the mean change or mean percentage change in serum creatinine between the control and nifedipine groups. The mean changes in serum creatinine we re +7.4 mu mol/l in the control group and +2.7 mu mol/L in the nifedip ine group (p=0.33); the mean percentage changes were +10.2% and +4.8%, respectively (p=0.54). Conclusion. Regardless of statistical analysis , it is unlikely that elevations in serum creatinine of this magnitude (< 0.1 mg/dl) are of clinical significance. We therefore conclude tha t prophylactic nifedipine is not clinically beneficial in preserving r enal function in patients receiving contrast medium and that the agent should not be routinely administered for this purpose.