The Effect of Atorvastatin Combining with Probucol on Contrast-induced Acute Kidney Injury in Patients with Hypertension

Background Perioperative intervention therapy with atorvastatin or probucol could reduce contrast induced acute kidney injury(CIAKI),but the effects of combination treatment of the two drugs on CIAKI in patients with hypertension remained unknown.Objective To evaluate the effects of different doses of atorvastatin combined with or without probucol on CIAKI in patients with hypertension experiencing coronary angiography(CAG)or percutaneous coronary intervention(PCI).Methods One hundred twenty-six patients admitted for CAG or PCI were randomly divided into 3 groups.Low-dose combination treatment group(L-C group,n=41):atorvastatin 20 mg/d and probucol 250 mg,3/d;high-dose combination treatment group(H-C group,n=40):atorvastatin 40 mg/d and probucol 250 mg,3/d,with a further dose of atorvastatin 40 mg and probucol 500 mg 2 hours before intervention;high-dose atorvastatin treatment group(H-A group,n=45):atorvastatin 40 mg/d,with a further dose of atorvastatin 40 mg 2 hours before procedure.In all 126 patients,blood samples were collected before and 24 h after angioplasty to measure serum creatinine(Scr),blood urea nitrogen(BUN),renin activity,angiotensin Ⅱ(Ang Ⅱ)and aldosterone level.Glomerular filtration rate(eGFR)were estimated using the modified diet in renal disease study(MDRD)formula.Results ① After angioplasty,Scr in L-C group and H-A group increased significantly,while eGFR of the two groups decreased markedly;In H-C group,BUN decreased significantly after treatment,Scr and eGFR showed no significant changes.②ΔScr in H-C group was significantly higher [(-2.6±14.6)vs(7.4±21.4),(5.4±10.6)μmol/L,both P0.05] and ΔeGFR was markedly lower than that of the other two groups [(1.4±11.2)vs(-4.5±10.6),(-4.3±10.4)mL/min,both P0.05].Conclusion For hypertensive patients,combination and intensive treatment of atorvastatin and probucol before angiography could attenuate the CIAKI.