Evaluation of combination therapy with vitamin C and pentoxifylline on preventing kidney failure secondary to intravenous contrast material in coronary angioplasty

Background- Contrast nephropathy is the third leading cause of new-onset renal failure in hospitalized patients. Contrast nephropathy has been associated with increased in-hospital and long-term morbidity and mortality. Several interventions for the prevention of contrast nephropathy have been tested in clinical trials. Recent studies have produced conflicting results regarding the efficacy of the antioxidant agents. Objectives- The aim of this study was to evaluate the preventive effect of Pentoxifylline and Ascorbic Acid on contrast-induced nephropathy. Methods and Materials- This clinical trial study was done in 2012 in Rajaie Cardiovascular, Medical and Research Center. Totally, 328 patients who were candidated for coronary artery angioplasty were entered in the study. Pentoxifylline and Ascorbic Acid 24 hours before the procedure and 24 hours after the procedure were administered orally in 164 patients (case group), and the 164 patients did not receive the medication (control group), randomly. Contrast nephropathy was defined by an absolute increase of serum creatinine >0.5 mg/dL or a relative increase of >25 measured after the procedure. Contrast nephropathy was compared between the two groups. Results- Totally, 121 (73.8) patients in the case group and 113 (68.9) in the control group were male (p value=0.329). Mean of age was 58.8±10 and 58.5±10.5 years in the case and control groups, respectively (p value=0.756). Contrast nephropathy was detected in 14 (8.5) patients in the case group and 23 (14) in the control group (p value=0.116; odds ratio=0.572, CI 95: 0.243-1.150). Conclusions- Prophylactic oral administration of Pentoxifylline and Ascorbic Acid could not protect against contrast nephropathy in the patients undergoing a coronary procedure. More future studies are necessary for final judgment