C1-inhibitor may help prevent contrast-induced nephropathy

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Given before coronary angiography in high-risk patients, recombinant human C1-esterase-inhibitor (rhC1INH) reduces biomarkers for contrast-induced kidney injury, reports a trial in JACC: Cardiovscular Interventions.

The Prophylactic RhC1-inhibitor to Prevent Contrast-induced Nephropathy (PROTECT) trial included 77 high-risk patients scheduled for elective coronary angiography. All had an eGFR of ≤50 mL/min per 1.73 m2 plus one additional risk factor (diabetes, age ≥75, anemia, congestive heart failure, or history of pulmonary edema). The patients were 54 men and 23 women, mean age 77 years and mean eGFR 40 mL/min per 1.73 m2.

Patients were randomly