A Study to Explore the Efficacy of Alprostadil Liposomes Injection in the Prevention of CI-AKI
Contrast-induced Acute Kidney Injury
About this trial
This is an interventional prevention trial for Contrast-induced Acute Kidney Injury
Eligibility Criteria
Inclusion Criteria:
1. Agree to participate in this clinical trial and sign the informed consent voluntarily; 2.18≤age≤80 years old, gender is not limited; 3.Suffering from coronary artery disease and preparing to undergo elective PCI; 4.Serum creatinine>1.5 mg/dL or 30≤eGFR<60 mL/(min·1.73m^2), and meet at least one of the following risk factors:
- Cardiac function class NYHA class III;
- Age > 75 years old;
- Anemia (baseline hematocrit: <36% in women, <39% in men);
- Diabetes.
Exclusion Criteria:
- Pre-perform emergency PCI;
- Previously allergic to alprostadil similar products and contrast agents; used alprostadil within 3 days before the first administration;
- Severe renal insufficiency: renal replacement therapy may be performed in a short period of time or eGFR<30 mL/(min·1.73m^2);
- Severe heart failure (LVEF <35% or NYHA class IV), acute heart failure, and pulmonary edema;
- Requires mechanical circulatory support therapy (intra-aortic balloon pump, catheter-based ventricular assist device, venous-arterial extracorporeal membrane oxygenation therapy, etc.);
- Hypotension: systolic blood pressure < 90 mmHg;
- Acute bleeding disorders or bleeding tendency, and the investigators believe that they are not suitable to participate in this trial;
- Severe anemia (hemoglobin <60 g/L);
- Active hepatitis B virus infection (positive hepatitis B virus surface antigen and the quantitative detection value of hepatitis B virus DNA exceeds the upper limit of the normal range of the research center), positive for any one of hepatitis C virus antibody, HIV antibody, and Treponema pallidum antibody;
- Abnormal liver function (alanine aminotransferase (ALT) or aspartate aminotransferase (AST) ≥ 3 times the upper limit of normal);
- Contrast agents or known nephrotoxic drugs (aminoglycoside antibiotics, amphotericin B, vancomycin, antiviral drugs, non-steroidal anti-inflammatory drugs (except aspirin), Immunosuppressants, traditional Chinese medicines and proprietary Chinese medicines containing aristolochic acid, etc.) within 14 days before the first application of the test drug, or the use of drugs that protect the kidneys against AKI (N-acetylcysteine, sodium bicarbonate, aminophylline) within 3 days before the first application of the test drug;
- Severe renal artery stenosis, and in the opinion of the the investigator, is unsuitable to participate in this trial;
- Electrolyte disorders (serum potassium <2.5 mmol/L or serum sodium <125 mmol/L);
- A history of glaucoma or ocular hypertension or gastric ulcer;
- Interstitial pneumonia or mental illness or dementia;
- Malignant tumors;
- Have participated in drug clinical trials and used drugs within 3 months before screening;
- Pregnant or breastfeeding, or patients who cannot use effective contraception during the study;
- Other patients deemed unsuitable for participation in this trial by the investigator.
Sites / Locations
- Beijing University First HospitalRecruiting
Arms of the Study
Arm 1
Arm 2
Arm 3
Arm 4
Experimental
Experimental
Experimental
No Intervention
20 µg group
40 µg group
80 µg group
blank control group
Patients will receive alprostadil liposome injection at 20 µg once daily (QD) for 4 days (1 to 3 hours before surgery and 3 days after surgery).
Patients will receive alprostadil liposome injection at 40 µg once daily (QD) for 4 days (1 to 3 hours before surgery and 3 days after surgery)
Patients will receive alprostadil liposome injection at 80 µg once daily (QD) for 4 days (1 to 3 hours before surgery and 3 days after surgery)
Patients will receive only basic hydration therapy which the experimental groups will receive.