Efficacy of Enhanced External Counterpulsation in Reducing Contrast-Induced Acute Kidney Injury in Males with Chronic Kidney Disease

Abstract

Background: Among the cases of coronary angiography (CAG)/percutaneous coronary intervention (PCI), men count higher for these cases, and they are more prone to renal injury when they have renal insufficiency. Recent research suggests that enhanced external counterpulsation (EECP) could be a new technique for preventing contrast-induced acute kidney injury (CI-AKI). In the current study, we aimed to conduct evaluation on the prevention of CI-AKI in makes through efficacy of EECP with chronic kidney disease (CKD) through the comparison on the change in renal function indexes after CAG/PCI. Methods: The male patients totaling to 234 with CKD who underwent CAG/PCI from December 2020 to February 2022 were selected and assigned to two distinct categories: Control group (n = 80) and observation group (n = 154). Patients in the control group received hydration treatment before and after CAG/PCI, while in the observation group patients received EECP regarding on the treatment received in the control group. Changes in renal function indexes were compared in both groups before and after CAG/PCI. Results: The group of patients under the observations showed significant lower blood urea nitrogen (BUN) and Cystatin-c (Cys-c) after CAG/PCI (6.5 ± 2.4 vs 7.3 ± 3.1, p = 0.040 and 1.7 ± 0.6 vs 1.6 ± 0.4, p = 0.038) than the control group. BUN and Scr (serum creatinine) was significantly lower in the observation group which indicated (6.5 ± 2.4 vs 8.2 ± 3.0, p < 0.001 and 146.4 ± 38.3 vs 155.1 ± 37.6, p < 0.001). It shows significant higher rate of estimated glomerular filtration (eGFR) was significantly higher (47.8 ± 13.5 vs 43.9 ± 10.7, p < 0.001) after CAG/PCI. More patients had increased eGFR (62.3% vs 47.5%, p = 0.030) the incidence of contrast-induced nephropathy (CIN) and acute kidney injury (AKI) in the observation group was lower (2.6% vs 10.0%, p = 0.015 and 1.3% vs 6.3%, p = 0.035). EECP was an independent protective factor for AKI odds ratio [OR] = 0.244, 95% confidence interval [CI] 0.069–0.857, p = 0.028) and the same trend was seen for CIN, but it did not show significant statistics in (p = 0.065). Conclusions: The application of EECP can enhance the reduction of the risk of CI-AKI/CIN and renal function in elderly males with CKD after CAG/PCI.