J Korean Med Sci.  2019 Oct;34(40):e261. 10.3346/jkms.2019.34.e261.

The Prevention of Contrast Induced Nephropathy by Sarpogrelate: a Prospective Randomized Controlled Clinical Trial

• Ki YJ
• Kwon SA
• Kim HL
• Seo JB
• Chung WY

• KMID: 2460037
• DOI: http://doi.org/10.3346/jkms.2019.34.e261

Abstract

BACKGROUND
Although some strategies are used for prophylaxis of contrast induced nephropathy, their efficacy is not fully established. Sarpogrelate can relieve vasospasm and have anti-inflammatory action. This study examined whether sarpogrelate reduces the incidence of contrast induced nephropathy (CIN) or subsequent renal impairment during four weeks after coronary angiography compared with a control group.
METHODS
Seventy-four participants with chronic renal failure were randomly assigned to the sarpogrelate or control group. Patients assigned to the sarpogrelate group received oral saporogelate from 24 hours before contrast exposure up to one month after contrast exposure. The primary outcome of this study was the incidence of CIN within 48 hours after exposure to the contrast agent.
RESULTS
Thirty-one subjects in the control group and 35 subjects in the sarpogrelate group were used for the analysis. Cumulative CIN occurred numerically more at 48 hours in the sarpogrelate group and less at one month without statistical significance (11.4% vs. 6.5% at 48 hours and 11.4% vs. 16.1% at one month, respectively). Baseline renal function was similar in both groups, but the estimated glomerular filtration rate (eGFR) was lower in the sarpogrelate group at 12 and 48 hours compared with the control group (45.6 vs. 54.7 mL/min/1.73m²; P = 0.023 and 39.9 vs. 50.6 mL/min/1.73m²; P = 0.020, respectively). At one month, the eGFR became comparable between the two groups because the eGFR was aggravated in the control group and maintained in the sarpogrelate group.
CONCLUSION
This study failed to demonstrate that sarpogrelate has a renoprotective effect against contrast induced acute kidney injury. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT01165567

Keyword

Contrast Nephropathy; Coronary Angiography; Renal Insufficiency; Sarpogrelate; Serotonin

MeSH Terms

Acute Kidney Injury
Coronary Angiography
Glomerular Filtration Rate
Humans
Incidence
Kidney Failure, Chronic
Prospective Studies*
Renal Insufficiency
Serotonin
Serotonin