The next Nephrology Twitter Journal Club (@NephJC) will discuss the POSEIDON Trial which has been published in The Lancet. Interest in the prevention of Contrast Induced Nephropathy (CIN) is alive and well with several novel approaches/therapies being recently reported (see my recent post), mostly in non-Nephrology journals. Despite these interventions, volume expansion remains the cornerstone of preventative management for CIN (contrast-induced acute kidney injury is just too much of a mouthful for me).
This current trial randomized patients into 2 protocols of 0.9% NaCl-based volume expansion peri-cardiac catheterization. The study group had their fluid rate governed by left ventricular end diastolic volume, measured easily during the catheterization procedure and used as a surrogate for volume status. This allowed the intervention group patients to safely receive higher volumes of saline during their procedures which translated into significantly lower rates of CIN. Obviously this method can only be conveniently employed during catheterization procedures and would need the involvement of interested cardiologists for it to be used in real-life clinical practice. However, the results appear impressive.
You can read a concise summary of the trial and results over at NephJC. Be sure to tune into Twitter on Wednesday June 25th at 9pm Eastern and feel free to get involved using #NephJC.