Effect of Melatonin Administration on Prevention of Contrast- Induced Nephropathy following Coronary Angiography

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Introduction. Contrast-induced-nephropathy (CIN) is a common complication during angiography that may lead to long-term complications. This study was conducted to investigate the effect of melatonin administration on prevention of CIN in patients who underwent coronary angiography with intra-arterial contrast agents. Method. This is single-blind randomized clinical trial that was performed over 100 patients with indication for coronary angiography. Patients are randomly assigned to two equal groups. All patients in the 12 hours before and 12 hours after the procedure, were received adequate intravenous hydration with normal saline and for the intervention group in addition to hydration, the day before angiography and immediately after angiography 3 mg melatonin was administered. For all patients, serum level of creatinine (Cr), blood urea nitrogen (BUN) and glomerular filtration rate (GFR) before and 48 hours after the procedure were measured. Data were analyzed using SPSS 18 software. Results. Totally 100 participants with the mean age of 64.0±8.2 years were enrolled (63% male). There was no significant difference between intervention and control groups in baseline and demographic characteristics (P> 0.05). Although the mean serum Cr and BUN level increased in both groups, but the mean Cr, BUN and GFR before and after coronary angiography was not statistically significant. Based on the definition of CIN in the current study, 3(6%) patients from intervention group and 2(4%) patients from control group were affected by CIN (P = 0.243). Conclusion. It is likely that, melatonin administration has no significant effect on prevention of CIN following coronary angiography.

1. Tepel M. Acetylcysteine for the prevention of radiocontrastinduced nephropathy. Minerva cardioangiologica 2003; 51(5): 525-530.

2. O’sullivan S, Healy D, Moloney MC, et al. The Role of N-Acetylcysteine in the Prevention of Contrast-Induced Nephropathy in Patients Undergoing Peripheral Angiography A Structured Review and Meta-Analysis. Angiology 2013; 64(8): 576-582.

3. Barrett BJ, Parfrey PS. Preventing nephropathy induced by contrast medium. New England Journal of Medicine 2006; 354(4): 379-386.

4. Abushouk AI, Taheri MS, Pooransari P, et al. Pregnancy Screening before Diagnostic Radiography in Emergency Department; an Educational Review. Emergency 2017; 5(1): 60.

5. Hashemi B, Safari S, Hosseini M, et al. A Systematic Review of Iranian Experiences in Seismo-Nephrology. Archives of trauma research 2016; 5(2): e28796.

6. Stacul F, van der Molen AJ, Reimer P, et al. Contrast induced nephropathy: updated ESUR contrast media safety committee guidelines. European radiology 2011; 21(12): 2527-2541.

7. Thomsen H, Morcos S. Contrast media and the kidney: European Society of Urogenital Radiology (ESUR) guidelines. The British journal of radiology 2003; 76(908): 513-518.

8. Persson PB, Hansell P, Liss P. Pathophysiology of contrast medium-induced nephropathy. Kidney international 2005; 68(1): 14-22.

9. Mehran R, Nikolsky E. Contrast-induced nephropathy: definition, epidemiology, and patients at risk. Kidney international Supplement 2006; (100): S11-S15.

10. Saitoh T, Satoh H, Nobuhara M, et al. Intravenous glutathione prevents renal oxidative stress after coronary angiography more effectively than oral N-acetylcysteine. Heart and vessels 2011; 26(5): 465-472.

11. Safari S, Yousefifard M, Hashemi B, et al. The value of serum creatine kinase in predicting the risk of rhabdomyolysis- induced acute kidney injury: a systematic review and meta-analysis. Clinical and experimental nephrology 2016; 20(2): 153-161.

12. Safari S, Yousefifard M, Hashemi B, et al. The Role of Scoring Systems and Urine Dipstick in Prediction of Rhabdomyolysis- induced Acute Kidney Injury: a Systematic Review. Iranian journal of kidney diseases 2016; 10(3): 101-106.

13. Goldenberg I, Shechter M, Matetzky S, et al. Oral acetylcysteine as an adjunct to saline hydration for the prevention of contrast-induced nephropathy following coronary angiography. A randomized controlled trial and review of the current literature, 2004.

14. Weisbord SD, Palevsky PM. Radiocontrast-induced acute renal failure. Journal of Intensive Care Medicine 2005; 20(2): 63-75.

15. McCullough PA. Contrast-induced acute kidney injury. Journal of the American College of Cardiology 2008; 51(15): 1419-1428.

16. Stevens M, McCullough P, Tobin K, et al. A prospective randomized trial of prevention measures in patients at high risk for contrast nephropathy: results of the PRINCE Study. Prevention of Radiocontrast Induced Nephropathy Clinical Evaluation. Journal of the American College of Cardiology 1999; 33(2): 403-411.

17. Allaqaband S, Tumuluri R, Malik A, et al. Prospective randomized study of N-acetylcysteine, fenoldopam, and saline for prevention of radiocontrast-induced nephropathy. Catheterization and cardiovascular interventions. Official journal of the Society for Cardiac Angiography & Interventions 2002; 57(3): 279-283.

18. Wilhelmsen M, Amirian I, Reiter R, et al. Analgesic effects of melatonin: a review of current evidence from experimental and clinical studies. Journal of pineal research 2011; 51(3): 270-277.

19. Peres M. Melatonin, the pineal gland and their implications for headache disorders. Cephalalgia: an international journal of headache 2005; 25(6): 403-411.

20. Sezgin G, Ozturk G, Guney S, et al. Protective effect of melatonin and 1, 25-dihydroxyvitamin D3 on renal ischemiareperfusion injury in rats. Renal failure 2012; 35(3): 374-379.

21. Hara M, Yoshida M, Nishijima H, et al. Melatonin, a pineal secretory product with antioxidant properties, protects against cisplatin-induced nephrotoxicity in rats. Journal of pineal research 2001; 30(3): 129-138.

22. Nasri H, Tavakoli M, Ahmadi A, et al. Ameliorative effect of melatonin against contrast media induced renal tubular cell injury. Pakistan journal of medical sciences 2014; 30(2): 261-265.

23. Murphy SW, BARRETT BJ, Parfrey PS. Contrast nephropathy. Journal of the American Society of Nephrology 2000; 11(1): 177-182.

24. Bailey SR. Past and present attempts to prevent radiocontrast nephropathy. Reviews in cardiovascular Medicine 2000; 2: S14- S18.

25. Bagshaw S, Ghali W. Theophylline for prevention of contrast-induced nephropathy: a systematic review and meta-analysis, 2005.

26. Gazi S, Altun A, Erdogan O. Contrast-induced nephropathy: preventive and protective effects of melatonin. Journal of pineal research 2006; 41(1): 53-57.

27. Kilic U, Kilic E, Tuzcu Z, et al. Melatonin suppresses cisplatin- induced nephrotoxicity via activation of Nrf-2/HO-1 pathway. Nutrition & metabolism 2012; 10(1): 7-.

28. Zararsiz I, Sarsilmaz M, Tas U, et al. Protective effect of melatonin against formaldehyde-induced kidney damage in rats. Toxicology and industrial health 2007; 23(10): 573-579.

29. Lee I, Kim S, Lee S, et al. Melatonin attenuates gentamicin- induced nephrotoxicity and oxidative stress in rats. Archives of toxicology 2012; 86(10): 1527-1536.

30. Millea P. N-acetylcysteine: multiple clinical applications. American family physician 2009; 80(3): 265-269.

31. Michels WM, Grootendorst DC, Verduijn M, et al. Performance of the Cockcroft-Gault, MDRD, and New CKDEPI Formulas in Relation to GFR, Age, and Body Size. Clinical Journal of the American Society of Nephrology. CJASN 2010; 5(6): 1003-1009.

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