الفهرس 
Comparison between carvedilol and atorvastatin in the prevention of contrast induced nephropathy in patientsundergoing cardiac catheterization
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Abstract
Background: Contrast-induced nephropathy (CIN) is responsible for a third of all hospital-acquired acute kidney injury (AKI), associated with increased morbidity, the need for short-term hemodialysis, and extended hospitalization. Although several preventive measures have been used, the best approach to prevent or reverse contrast induced nephropathy is still controversial. Objectives:This study is intended to evaluate the protective effect of carvedilol/medium dose atorvastatin compared to the recommended high dose atorvastatin on the development of CIN in patients undergoing elective cardiac catheterization (CC). Methods: A total of 144 patients planned for CC were randomly assigned to: group (A): 49 patients received atorvastatin as single high dose 80 mg 12 hours before CC and another 40 mg of atorvastatin 2 hours before CC. group (B): 48 patients were prescribed carvedilol 12.5 mg twice daily for seven days before CC and continued for 24 hours post CC, plus 40 mg atorvastatin 12 hours before CC.group (C): 47 patients received 40 mg atorvastatin 12 hours before the CC. All included patients were hydrated with intravenous 0.9% sodium chloride (NaCl) at 0.5-1 ml/kg/hour for 4-6 hours before and 4-6 hours after CC. All patients were evaluated for the following parameters: Serum creatinine (SCr) baseline (before initiating the hydration) and 48 hours after the CC procedure to evaluate the incidence of CIN (defined as absolute rise in the baseline SCr concentration by 0.5 mg/dL after 48 hours from CC); serum blood urea nitrogen (BUN) was measured before and 48 hours post-CC; creatinine clearance (CrCl) was calculated using Cockcroft{u2013}Gault (CG) equation on admission, and re-calculated 48 hours post CC using CG equation for all patients except for patients who showed > 0.5 mg/dL rise in SCr where, Jelliffe and Jelliffe equation was used for unstable kidney cases and serum neutrophil gelatinous associated lipocaline (NGAL) baseline was measured before the initiation of hydration, and 4 hours after CC procedure