Allopurinol and Trimetazidine as a Preventive of Acute Kidney Injury in PCI Patients

• Status: Not yet recruiting
• Trial end date: 2025-09-01
• Target enrollment: 0
• Participant gender: All

Summary

Contrast-associated acute kidney injury (CA-AKI) is a common complication of procedures with intravascular contrast. Generally, CA-AKI is defined as serum creatinine (Scr) ≥ 25 to 50% or Scr rise around 0.3 to 0.5 mg/dl. The initial rise in SCr is typically seen within 48 to 72 h of contrast exposure .CA-AKI has been associated with increased hospital length of stay and excess costs. Therefore, the prevention of CA-AKI is beneficial for minimizing hospital costs, mortality and morbidity. Till now, what is clearly beneficial in CIN is adequate hydration before and after coronary angiography However, further measures are trialed, aiming to reduce more morbidity and mortality. There is a great deal of publications pertaining to the possible therapeutic interventions to avoid the ultimate outcome of complete kidney failure. Accordingly, allopurinol has been suggested as a promising measure for the prevention of acute kidney injury after coronary angiography through protecting the kidney by inhibiting XO activity and blocking the generation of oxygen radicals. However, studies have shown conflicting results. Trimetazidine is cellular anti-ischemic drug which has been shown to protect against free radical damage due to its antioxidant activity. It has been recently shown to decrease the risk of CIN in percutaneous coronary intervention (PCI) in some studies. However, it is worth mentioning that studies evaluating trimetazidine under presented patients with high estimated glomerular filtration rate (eGFR). Accordingly, Aimed to evaluate the combination of trimetazidine with allopurinol versus using trimetazidine alone to define the most effective strategy to be implemented in the clinical setting in patients with diverse risk factors and normal GFR.

• Phase: Phase 4
• Accepts Healthy Volunteers?: Accepts Healthy Volunteers

Details

• Lead Sponsor: Beni-Suef University
• Collaborator: Cairo University
• Treatments: Allopurinol; Trimetazidine

Criteria

Inclusion Criteria:

• All patients willing to undergo PCI with low, moderate or high risk of CIN based on Mehran risk score (4)

• Age 18 - 80 years

• Patients with GFR > 60 ml/min

Exclusion Criteria:

• Age <18 or > 80 years

• Acute kidney injury

• Renal insufficiency (eGFR < 60 mL/min)

• Gout (serum uric > 10 mg/dL)

• History of allopurinol intake.

• Hepatic failure.

• Pregnancy or lactation,

• History of allergy to contrast agents, allopurinol or trimetazidine

• Any nephrotoxic drug intake within 48 hrs. before the procedure

• Pulmonary edema, cardiogenic shock and mechanical ventilation.