Prophylactic Effect of Theophylline in Renal Contrast Nephropathy after Coronary Angiography

Contrast nephropathy will increase mortality up to 30% following angiographic procedures. Adenosine is a crucial mediator of contrast-induced nephropathy. The purpose of this study was to investigate whether the adenosine antagonist Theophylline reduces the incidence of CN after coronary angiography. In this randomized, double-blind, placebo-controlled clinical trial study, carried out from February 2004 to September 2005 at the Fatemeh Zahra Hospital, 70 patients who were undergoing coronary angiography were divided into two groups. Case group (n=35) received oral Theophylline 200 mg bid. 24 h before and for 48 h after angiography. The control group (n=35) received placebo. Serum Na+, K+, blood urea nitrogen (BUN), creatinine, glomerular filtration rate (GFR) were measured before and after angiography. In the case group there were no significant change in serum creatinine (0.90± 0.7 vs. 0.92±0.3 mg/dl), BUN (17.76±7.8 vs. 19.35±9.6 mg/dl), GFR (83.01±26.7 vs. 81.36±24.9 ml/min) Na+ (139.08±3.6 vs. 138.54±2.7 mEq/l) and K+ (4.30±0.4 vs. 4.19±0.3 mEq/l). In the control group, there was a significant fall in GFR after angiography (86.10±34.8 vs. 80.7±30.4 ml/min, P=0.03). Following angiography, there were no significant difference in serum creatinine, BUN, GFR, Na+ and K+ level between the two groups. None of the patients in either group faced contrast induced nephropathy. Theophylline does not appear to add a protective role in preventing against contrast induced nephropathy in patients undergoing angiographic procedures.