Skip to main content
Top
Published in: Trials 1/2010

Open Access 01-12-2010 | Study protocol

The prevention of contrast induced nephropathy by sarpogrelate in patients with chronic kidney disease: a study protocol for a prospective randomized controlled clinical trial

Authors: Kyungil Park, Woo-Young Chung, Jae-Bin Seo, Sang-Hyun Kim, Joo-Hee Zo, Myung-A Kim, Young-Bae Park

Published in: Trials | Issue 1/2010

Login to get access

Abstract

Background

Contrast-induced nephropathy (CIN) is a serious clinical problem associated with increased morbidity and mortality, particularly in patients with chronic renal insufficiency. Although some agents including hydration with saline are being prescribed to prevent renal deterioration in these high risk patients, their efficacy is not clearly defined and debatable. Therefore additional prophylactic pretreatments are needed.

Methods/Design

The present study aims to investigate differences in occurrence of CIN after sarpogrelate premedication in patients with chronic kidney disease (CKD). 268 participants, aged 20-85 years with a clinical diagnosis of CKD will be recruited. They will be randomly allocated to one of two conditions: (i) routine treatment without sarpogrelate, and (ii) routine treatment with sarpogrelate (a fixed-flexible dose of 300 mg/day). The primary outcome is the occurrence of CIN during 4 weeks after receiving contrast agent.

Discussion

As of May 2010, there were no registered trials evaluating the therapeutic potentials of sarpogrelate in preventing for CIN. If sarpogrelate decreases the worsening of renal function and occurrence of CIN, it will provide a safe, easy and inexpensive treatment option.

Trial registration

NCT01165567
Appendix
Available only for authorised users
Literature
1.
go back to reference Weisbord SD, Chen H, Stone RA, Kip KE, Fine MJ, Saul MI, Palevsky PM: Associations of increases in serum creatinine with mortality and length of hospital stay after coronary angiography. J Am Soc Nephrol. 2006, 17: 2871-2877. 10.1681/ASN.2006030301.CrossRefPubMed Weisbord SD, Chen H, Stone RA, Kip KE, Fine MJ, Saul MI, Palevsky PM: Associations of increases in serum creatinine with mortality and length of hospital stay after coronary angiography. J Am Soc Nephrol. 2006, 17: 2871-2877. 10.1681/ASN.2006030301.CrossRefPubMed
2.
go back to reference Gruberg L, Mintz GS, Mehran R, Gangas G, Lansky AJ, Kent KM, Pichard AD, Satler LF, Leon MB: The prognostic implications of further renal function deterioration within 48 h of interventional coronary procedures in patients with pre-existent chronic renal insufficiency. J Am Coll Cardiol. 2000, 36: 1542-1548. 10.1016/S0735-1097(00)00917-7.CrossRefPubMed Gruberg L, Mintz GS, Mehran R, Gangas G, Lansky AJ, Kent KM, Pichard AD, Satler LF, Leon MB: The prognostic implications of further renal function deterioration within 48 h of interventional coronary procedures in patients with pre-existent chronic renal insufficiency. J Am Coll Cardiol. 2000, 36: 1542-1548. 10.1016/S0735-1097(00)00917-7.CrossRefPubMed
3.
go back to reference McCullough PA, Wolyn R, Rocher LL, Levin RN, O'Neill WW: Acute renal failure after coronary intervention: incidence, risk factors, and relationship to mortality. Am J Med. 1997, 103: 368-375. 10.1016/S0002-9343(97)00150-2.CrossRefPubMed McCullough PA, Wolyn R, Rocher LL, Levin RN, O'Neill WW: Acute renal failure after coronary intervention: incidence, risk factors, and relationship to mortality. Am J Med. 1997, 103: 368-375. 10.1016/S0002-9343(97)00150-2.CrossRefPubMed
4.
go back to reference Rudnick MR, Berns JS, Cohen RM, Goldfarb S: Contrast media-associated nephrotoxicity. Semin Nephrol. 1997, 17: 15-26.PubMed Rudnick MR, Berns JS, Cohen RM, Goldfarb S: Contrast media-associated nephrotoxicity. Semin Nephrol. 1997, 17: 15-26.PubMed
5.
go back to reference Rihal CS, Textor SC, Grill DE, Berger PB, Ting HH, Best PJ, Singh M, Bell MR, Barsness GW, Mathew V, Garratt KN, Holmes DR: Incidence and prognostic importance of acute renal failure after percutaneous coronary intervention. Circulation. 2002, 105: 2259-2264. 10.1161/01.CIR.0000016043.87291.33.CrossRefPubMed Rihal CS, Textor SC, Grill DE, Berger PB, Ting HH, Best PJ, Singh M, Bell MR, Barsness GW, Mathew V, Garratt KN, Holmes DR: Incidence and prognostic importance of acute renal failure after percutaneous coronary intervention. Circulation. 2002, 105: 2259-2264. 10.1161/01.CIR.0000016043.87291.33.CrossRefPubMed
6.
go back to reference Merten GJ, Burgess WP, Gray LV, Holleman JH, Roush TS, Kowalchuk GJ, Bersin RM, Van Moore A, Simonton CA, Rittase RA, Norton HJ, Kennedy TP: Prevention of contrast-induced nephropathy with sodium bicarbonate: a randomized controlled trial. JAMA. 2004, 291: 2328-2334. 10.1001/jama.291.19.2328.CrossRefPubMed Merten GJ, Burgess WP, Gray LV, Holleman JH, Roush TS, Kowalchuk GJ, Bersin RM, Van Moore A, Simonton CA, Rittase RA, Norton HJ, Kennedy TP: Prevention of contrast-induced nephropathy with sodium bicarbonate: a randomized controlled trial. JAMA. 2004, 291: 2328-2334. 10.1001/jama.291.19.2328.CrossRefPubMed
7.
go back to reference Kay J, Chow WH, Chan TM, Lo SK, Kwok OH, Yip A, Fan K, Lee CH, Lam WF: Acetylcysteine for prevention of acute deterioration of renal function following elective coronary angiography and intervention: a randomized controlled trial. JAMA. 2003, 289: 553-558. 10.1001/jama.289.5.553.CrossRefPubMed Kay J, Chow WH, Chan TM, Lo SK, Kwok OH, Yip A, Fan K, Lee CH, Lam WF: Acetylcysteine for prevention of acute deterioration of renal function following elective coronary angiography and intervention: a randomized controlled trial. JAMA. 2003, 289: 553-558. 10.1001/jama.289.5.553.CrossRefPubMed
8.
go back to reference Erley CM, Duda SH, Rehfuss D, Scholtes B, Bock J, Müller C, Osswald H, Risler T: Prevention of radiocontrast-media-induced nephropathy in patients with pre-existing renal insufficiency by hydration in combination with the adenosine antagonist theophylline. Nephrol Dial Transplant. 1999, 4: 1146-114. 10.1093/ndt/14.5.1146.CrossRef Erley CM, Duda SH, Rehfuss D, Scholtes B, Bock J, Müller C, Osswald H, Risler T: Prevention of radiocontrast-media-induced nephropathy in patients with pre-existing renal insufficiency by hydration in combination with the adenosine antagonist theophylline. Nephrol Dial Transplant. 1999, 4: 1146-114. 10.1093/ndt/14.5.1146.CrossRef
9.
go back to reference Stacul F, Adam A, Becker CR, Davidson C, Lameire N, McCullough PA, Tumlin J, CIN Consensus Working Panel: Strategies to reduce the risk of contrast-induced nephropathy. Am J Cardiol. 2006, 98: 59-77. 10.1016/j.amjcard.2006.01.024.CrossRef Stacul F, Adam A, Becker CR, Davidson C, Lameire N, McCullough PA, Tumlin J, CIN Consensus Working Panel: Strategies to reduce the risk of contrast-induced nephropathy. Am J Cardiol. 2006, 98: 59-77. 10.1016/j.amjcard.2006.01.024.CrossRef
10.
go back to reference Rudnick MR, Kesselheim A, Goldfarb S: Contrast-induced nephropathy: how it develops, how to prevent it. Cleve Clin J Med. 2006, 73: 75-87. 10.3949/ccjm.73.1.75.CrossRefPubMed Rudnick MR, Kesselheim A, Goldfarb S: Contrast-induced nephropathy: how it develops, how to prevent it. Cleve Clin J Med. 2006, 73: 75-87. 10.3949/ccjm.73.1.75.CrossRefPubMed
11.
go back to reference Recio-Mayoral A, Chaparro M, Prado B, Cózar R, Méndez I, Banerjee D, Kaski JC, Cubero J, Cruz JM: The reno-protective effect of hydration with sodium bicarbonate plus N-acetylcysteine in patients undergoing emergency percutaneous coronary intervention: the RENO Study. J Am Coll Cardiol. 2007, 49: 1283-1288. 10.1016/j.jacc.2006.11.034.CrossRefPubMed Recio-Mayoral A, Chaparro M, Prado B, Cózar R, Méndez I, Banerjee D, Kaski JC, Cubero J, Cruz JM: The reno-protective effect of hydration with sodium bicarbonate plus N-acetylcysteine in patients undergoing emergency percutaneous coronary intervention: the RENO Study. J Am Coll Cardiol. 2007, 49: 1283-1288. 10.1016/j.jacc.2006.11.034.CrossRefPubMed
12.
go back to reference Masuda M, Yamada T, Mine T, Morita T, Tamaki S, Tsukamoto Y, Okuda K, Iwasaki Y, Hori M, Fukunami M: Comparison of usefulness of sodium bicarbonate versus sodium chloride to prevent contrast-induced nephropathy in patients undergoing an emergent coronary procedure. Am J Cardiol. 2007, 100: 781-786. 10.1016/j.amjcard.2007.03.098.CrossRefPubMed Masuda M, Yamada T, Mine T, Morita T, Tamaki S, Tsukamoto Y, Okuda K, Iwasaki Y, Hori M, Fukunami M: Comparison of usefulness of sodium bicarbonate versus sodium chloride to prevent contrast-induced nephropathy in patients undergoing an emergent coronary procedure. Am J Cardiol. 2007, 100: 781-786. 10.1016/j.amjcard.2007.03.098.CrossRefPubMed
13.
go back to reference Katzberg RW, Morris TW, Burgener FA, Kamm DE, Fischer HW: Renal renin and hemodynamic responses to selective renal artery catheterization and angiography. Invest Radiol. 1977, 12: 381-388. 10.1097/00004424-197709000-00002.CrossRefPubMed Katzberg RW, Morris TW, Burgener FA, Kamm DE, Fischer HW: Renal renin and hemodynamic responses to selective renal artery catheterization and angiography. Invest Radiol. 1977, 12: 381-388. 10.1097/00004424-197709000-00002.CrossRefPubMed
14.
go back to reference Heyman SN, Brezis M, Epstein FH, Spokes K, Silva P, Rosen S: Early renal medullary hypoxic injury from radiocontrast and indomethacin. Kidney Int. 1991, 40: 632-642. 10.1038/ki.1991.255.CrossRefPubMed Heyman SN, Brezis M, Epstein FH, Spokes K, Silva P, Rosen S: Early renal medullary hypoxic injury from radiocontrast and indomethacin. Kidney Int. 1991, 40: 632-642. 10.1038/ki.1991.255.CrossRefPubMed
15.
go back to reference Heyman SN, Brezis M, Reubinoff CA, Greenfeld Z, Lechene C, Epstein FH, Rosen S: Acute renal failure with selective medullary injury in the rat. J Clin Invest. 1988, 82: 401-412. 10.1172/JCI113612.CrossRefPubMedPubMedCentral Heyman SN, Brezis M, Reubinoff CA, Greenfeld Z, Lechene C, Epstein FH, Rosen S: Acute renal failure with selective medullary injury in the rat. J Clin Invest. 1988, 82: 401-412. 10.1172/JCI113612.CrossRefPubMedPubMedCentral
16.
go back to reference Hara H, Kitajima A, Shimada H, Tamao Y: Antithrombotic effect of MCI-9042, a new antiplatelet agent on experimental thrombosis models. Thromb Haemost. 1991, 66: 484-488.PubMed Hara H, Kitajima A, Shimada H, Tamao Y: Antithrombotic effect of MCI-9042, a new antiplatelet agent on experimental thrombosis models. Thromb Haemost. 1991, 66: 484-488.PubMed
17.
go back to reference Miyata K, Shimokawa H, Higo T, Yamawaki T, Katsumata N, Kandabashi T, Tanaka E, Takamura Y, Yogo K, Egashira K, Takeshita A: Sarpogrelate, a selective 5-HT2A serotonergic receptor antagonist, inhibits serotonin-induced coronary artery spasm in a porcine model. J Cardiovasc Pharmacol. 2000, 35: 294-301. 10.1097/00005344-200002000-00018.CrossRefPubMed Miyata K, Shimokawa H, Higo T, Yamawaki T, Katsumata N, Kandabashi T, Tanaka E, Takamura Y, Yogo K, Egashira K, Takeshita A: Sarpogrelate, a selective 5-HT2A serotonergic receptor antagonist, inhibits serotonin-induced coronary artery spasm in a porcine model. J Cardiovasc Pharmacol. 2000, 35: 294-301. 10.1097/00005344-200002000-00018.CrossRefPubMed
18.
go back to reference Sharma SK, Zahradka P, Chapman D, Kumamoto H, Takeda N, Dhalla NS: Inhibition of serotonin-induced vascular smooth muscle cell proliferation by sarpogrelate. J Pharmacol Exp Ther. 1999, 290: 1475-1481.PubMed Sharma SK, Zahradka P, Chapman D, Kumamoto H, Takeda N, Dhalla NS: Inhibition of serotonin-induced vascular smooth muscle cell proliferation by sarpogrelate. J Pharmacol Exp Ther. 1999, 290: 1475-1481.PubMed
19.
go back to reference Hayashi T, Sumi D, Matsui-Hirai H, Fukatsu A, Arockia Rani PJ, Kano H, Tsunekawa T, Iguchi A: Sarpogrelate HCl, a selective 5-HT2A antagonist, retards the progression of atherosclerosis through a novel mechanism. Atherosclerosis. 2003, 168: 23-31. 10.1016/S0021-9150(03)00054-6.CrossRefPubMed Hayashi T, Sumi D, Matsui-Hirai H, Fukatsu A, Arockia Rani PJ, Kano H, Tsunekawa T, Iguchi A: Sarpogrelate HCl, a selective 5-HT2A antagonist, retards the progression of atherosclerosis through a novel mechanism. Atherosclerosis. 2003, 168: 23-31. 10.1016/S0021-9150(03)00054-6.CrossRefPubMed
20.
go back to reference Fujita M, Mizuno K, Ho M, Tsukahara R, Miyamoto A, Miki O, Ishii K, Miwa K: Sarpogrelate treatment reduces restenosis after coronary stenting. Am Heart J. 2003, 145: E16-10.1067/mhj.2003.176.CrossRefPubMed Fujita M, Mizuno K, Ho M, Tsukahara R, Miyamoto A, Miki O, Ishii K, Miwa K: Sarpogrelate treatment reduces restenosis after coronary stenting. Am Heart J. 2003, 145: E16-10.1067/mhj.2003.176.CrossRefPubMed
21.
go back to reference Hara H, Shimada H, Kitajima A, Tamao Y: Effect of (+/-)-2-(dimethylamino)-1-[[o-(m-methoxyphenethyl)phenoxy] methyl]ethyl hydrogen succinate on experimental models of peripheral obstructive disease. Arzneimittelforschung. 1991, 41: 616-620.PubMed Hara H, Shimada H, Kitajima A, Tamao Y: Effect of (+/-)-2-(dimethylamino)-1-[[o-(m-methoxyphenethyl)phenoxy] methyl]ethyl hydrogen succinate on experimental models of peripheral obstructive disease. Arzneimittelforschung. 1991, 41: 616-620.PubMed
22.
go back to reference Ichiyanagi N, Tsujii T, Masuda H, Kihara K, Goto M, Azuma H: Changed responsiveness of the detrusor in rabbits with alloxan induced hyperglycemia: possible role of 5-hydroxytryptamine for diabetic bladder dysfunction. J Urol. 2002, 168: 303-307. 10.1016/S0022-5347(05)64912-9.CrossRefPubMed Ichiyanagi N, Tsujii T, Masuda H, Kihara K, Goto M, Azuma H: Changed responsiveness of the detrusor in rabbits with alloxan induced hyperglycemia: possible role of 5-hydroxytryptamine for diabetic bladder dysfunction. J Urol. 2002, 168: 303-307. 10.1016/S0022-5347(05)64912-9.CrossRefPubMed
23.
go back to reference Kanai H, Hiromura K, Kuroiwa T, Maezawa A, Yano S, Naruse T: Role of serotonin in nephrotoxic serum nephritis in WKY rats. J Lab Clin Med. 1997, 129: 557-566. 10.1016/S0022-2143(97)90010-X.CrossRefPubMed Kanai H, Hiromura K, Kuroiwa T, Maezawa A, Yano S, Naruse T: Role of serotonin in nephrotoxic serum nephritis in WKY rats. J Lab Clin Med. 1997, 129: 557-566. 10.1016/S0022-2143(97)90010-X.CrossRefPubMed
24.
go back to reference Doggrell SA: The role of 5-HT on the cardiovascular and renal systems and the clinical potential of 5-HT modulation. Expert Opin Investig Drugs. 2003, 12: 805-823. 10.1517/13543784.12.5.805.CrossRefPubMed Doggrell SA: The role of 5-HT on the cardiovascular and renal systems and the clinical potential of 5-HT modulation. Expert Opin Investig Drugs. 2003, 12: 805-823. 10.1517/13543784.12.5.805.CrossRefPubMed
25.
go back to reference Ishimura E, Nishizawa Y, Emoto M, Shoji T, Inaba M, Kawagishi T, Morii H: Therapeutic effect of sarpogrelate, a new 5-hydroxytryptamine receptor 2A antagonist, on diabetic nephropathy and neuropathy. Nephron. 1997, 76: 227-229. 10.1159/000190175.CrossRefPubMed Ishimura E, Nishizawa Y, Emoto M, Shoji T, Inaba M, Kawagishi T, Morii H: Therapeutic effect of sarpogrelate, a new 5-hydroxytryptamine receptor 2A antagonist, on diabetic nephropathy and neuropathy. Nephron. 1997, 76: 227-229. 10.1159/000190175.CrossRefPubMed
26.
go back to reference Ogawa S, Takeuchi K, Sugimura K, Sato C, Fukuda M, Lee R, Ito S, Sato T: The 5-HT2 receptor antagonist sarpogrelate reduces urinary and plasma levels of thromboxane A2 and urinary albumin excretion in non-insulin-dependent diabetes mellitus patients. Clin Exp Pharmacol Physiol. 1999, 26: 461-464. 10.1111/j.1440-1681.1999.03056.x.CrossRefPubMed Ogawa S, Takeuchi K, Sugimura K, Sato C, Fukuda M, Lee R, Ito S, Sato T: The 5-HT2 receptor antagonist sarpogrelate reduces urinary and plasma levels of thromboxane A2 and urinary albumin excretion in non-insulin-dependent diabetes mellitus patients. Clin Exp Pharmacol Physiol. 1999, 26: 461-464. 10.1111/j.1440-1681.1999.03056.x.CrossRefPubMed
27.
go back to reference Takahashi T, Yano M, Minami J, Haraguchi T, Koga N, Higashi K, Kobori S: Sarpogrelate hydrochloride, a serotonin2A receptor antagonist, reduces albuminuria in diabetic patients with early-stage diabetic nephropathy. Diabetes Res Clin Pract. 2002, 58: 123-129. 10.1016/S0168-8227(02)00105-5.CrossRefPubMed Takahashi T, Yano M, Minami J, Haraguchi T, Koga N, Higashi K, Kobori S: Sarpogrelate hydrochloride, a serotonin2A receptor antagonist, reduces albuminuria in diabetic patients with early-stage diabetic nephropathy. Diabetes Res Clin Pract. 2002, 58: 123-129. 10.1016/S0168-8227(02)00105-5.CrossRefPubMed
28.
go back to reference Morcos SK, Thomsen HS, Webb JA: Contrast-media-induced nephrotoxicity: a consensus report. Contrast Media Safety Committee, European Society of Urogenital Radiology (ESUR). Eur Radiol. 1999, 9: 1602-1613. 10.1007/s003300050894.CrossRefPubMed Morcos SK, Thomsen HS, Webb JA: Contrast-media-induced nephrotoxicity: a consensus report. Contrast Media Safety Committee, European Society of Urogenital Radiology (ESUR). Eur Radiol. 1999, 9: 1602-1613. 10.1007/s003300050894.CrossRefPubMed
29.
go back to reference Nikolsky E, Aymong ED, Dangas G, Mehran R: Radiocontrast nephropathy: identifying the high-risk patient and the implications of exacerbating renal function. Rev Cardiovasc Med. 2003, 4 (Suppl 1): S7-S14.PubMed Nikolsky E, Aymong ED, Dangas G, Mehran R: Radiocontrast nephropathy: identifying the high-risk patient and the implications of exacerbating renal function. Rev Cardiovasc Med. 2003, 4 (Suppl 1): S7-S14.PubMed
30.
go back to reference The GUSTO Investigators: An international randomized trial comparing four thrombolytic strategies for acute myocardial infarction. N Engl J Med. 1993, 329: 673-682. 10.1056/NEJM199309023291001.CrossRef The GUSTO Investigators: An international randomized trial comparing four thrombolytic strategies for acute myocardial infarction. N Engl J Med. 1993, 329: 673-682. 10.1056/NEJM199309023291001.CrossRef
Metadata
Title
The prevention of contrast induced nephropathy by sarpogrelate in patients with chronic kidney disease: a study protocol for a prospective randomized controlled clinical trial
Authors
Kyungil Park
Woo-Young Chung
Jae-Bin Seo
Sang-Hyun Kim
Joo-Hee Zo
Myung-A Kim
Young-Bae Park
Publication date
01-12-2010
Publisher
BioMed Central
Published in
Trials / Issue 1/2010
Electronic ISSN: 1745-6215
DOI
https://doi.org/10.1186/1745-6215-11-122

Other articles of this Issue 1/2010

Trials 1/2010 Go to the issue