Intravenous Vitamin C to Prevent Contrast-Induced Nephropathy in Patients Undergoing Percutaneous Coronary Intervention

This retrospective cohort study aimed to evaluate the effects of the intravenous administration of vitamin C before and after exposure to the contrast medium for the prophylaxis of contrast-induced nephropathy (CIN) in patients undergoing coronary angiography. 

Data on 210 patients with chronic kidney disease (CKD) (defined as an estimated glomerular filtration rate ≤60 mL/min/1.73m2) were obtained through medical chart reviews and electronic data in 3 different groups: 1) no vitamin C administered, 2) vitamin C administered 30 minutes before angiography, and 3) vitamin C administered 30 minutes after angiography. Each group consisted of 70 patients, and vitamin C was administered intravenously. CIN incidence in all the groups was defined as an increase of 0.5 mg/dL or 25% in serum creatinine levels. 

Overall, CIN incidence was significantly lower in patients who received intravenous vitamin C before (P≤0.05) and after (P≤0.05) angiography than in patients with no prophylaxis. The post-angiography administration of vitamin C was very effective in diminishing creatinine rise and preventing CIN. CIN occurred in 7.1% of the patients in the pre-administered and post-administered groups. 

The intravenous administration of vitamin C before and after angiography could effectively decrease CIN incidence in patients undergoing percutaneous coronary intervention. The post-angiography administration of vitamin C is more effective to decrease serum creatinine levels. (Iranian Heart Journal 2022; 23(1): 149-159)