The Renoprotective Effectiveness of Single-dose Diltiazem in Patients Undergoing Coronary Angiography

In order to evaluate the possible protective effect of single-dose diltiazem injection on contrast-induced renal injury, we measured urinary enzymes and renal hemodynamics in both a control group (n:49) and a diltiazem group (n:5l) in 100 patients undergoing angiocardiography. Each patient collected 24 hour urine. The dilitiazem group received diltiazem i.v. single dose of 0.25 mg/kg (max 25 mg). No medications were given to the controls. Fifteen minutes Jater diltiazem patients were taken to the operation table and the angio cardiographic examination was performed. After the study patients were hospitalized and urine was collected in the following 48 hours. In each 24 hours sample (baseline, day 1, day 2), urine volumes were carefully noted. Creatinine elearence and fractional sodium exeretian (FENA) were calculated and, urine alan ine aminopeptidase N-Acetyl-B-Dglucosaminidase, and angiotensin converting enzyme activity were measured. Diltiazem did not create any changes in the markers representative of contrast-induced tubulotoxicity. However, serum erea tİnine levels reduced significııntly after contrast media in the diltiazem group. These data imply that diltiazem may be of importance in preventing contrast-induced renal injury. A further study, in which a more sensitive test for glomerular filtration rate is used and diltiazem is given in a longer period and/or higher dose should be performed in order to determine the exact role of calcium antagonists in renal protection against contrast-media nephrotoxicity.