Central venous pressure-guided hydration beneficial in CKD, CHF

(HealthDay)—For patients with chronic kidney disease (CKD) and congestive heart failure (CHF) undergoing coronary procedures, central venous pressure (CVP)-guided hydration is associated with reduced risk of contrast-induced nephropathy (CIN), according to a study published online Dec. 9 in JACC: Cardiovascular Interventions.

Geng Qian, M.D., from the Chinese People's Liberation Army General Hospital in Peking, and colleagues conducted a prospective comparative trial involving 264 patients with CKD and CHF undergoing coronary procedures. Patients were randomized to CVP-guided hydration or standard hydration (132 patients in each group). The hydration infusion rate was dynamically adjusted according to CVP level every hour in the CVP-guided group.

The researchers found that the total mean volume of isotonic saline administered was significantly higher in the CVP-guided hydration group than the control group (P < 0.001). CIN occurred less often in the CVP-guided hydration group (15.9 versus 29.5 percent in the control group; P = 0.006). There was no difference between the groups in the incidences of acute heart failure during the hydration (3.8 versus 3.0 percent; P = 0.500).

"CVP-guided fluid administration can safely and effectively reduce the risk of CIN in patients with CKD and CHF," the authors write.