Objectives Anisodamine is widely used in the therapy of acute glomerulonephritis and diabetic nephropathy because it can improve renal microcirculation. We performed a study to evaluate the preventive effects of anisodamine against contrast-induced nephropathy (CIN) in type 2 diabetics with renal insufficiency undergoing coronary angiography or angioplasty.
Methods A total of 260 patients with type 2 diabetes and an estimated glomerular filtration rate of (eGFR) 60 ml/min/1.73 m2 or less undergoing coronary angiography or angioplasty were randomly assigned to receive infusion of either sodium chloride (control group, n = 128) or anisodamine (treatment group, n = 132). Patients in treatment group received infusion of anisodamine at a rate of 0.2 μg/kg/min from 12 hours before to 12 hours after coronary angiography or angioplasty, while patients in control group received infusion of sodium chloride as the same volume as treatment group. All patients received intravenous sodium chloride hydration. Contrast-induced nephropathy is defined as a 25% increase in serum creatinine from baseline or an absolute increase of > 0.5 mg/dl within 3 days after contrast exposure. The primary end point was the incidence of CIN. The secondary end point was 25% or greater reduction in eGFR.
Results There were no significant differences between two groups with regard to age, gender, risk factors, laboratory results, medications and intervention. The incidence of CIN was 9.8% (13/132) in treatment group and 20.3% (26/128) in control group (P < 0.05). The secondary end point was 6.0% (8/132) in treatment group and 16.4% (21/128) in control group (P < 0.05).
Conclusions These results indicate the preventive effects of anisodamine against contrast-induced nephropathy in type 2 diabetics with renal insufficiency undergoing coronary angiography or angioplasty.