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Journal of Clinical Cardiology

ISSN: 2694-5088

Original Research Open Access
Volume 6 | Issue 2 | DOI: https://doi.org/10.33696/cardiology.6.082

Allopurinol for Prevention of Contrast-Induced Acute Kidney Injury in Patients Undergoing Percutaneous Coronary Intervention: A Randomized-Controlled Trial

Kareem Mahmoud1,*, Wadhah Hasan1, Hesham Taha1, Dalia ElRemisy1
  • 1Cardiology Department, Cairo University, Cairo, Egypt
+ Affiliations - Affiliations

Corresponding Author

Kareem Mahmoud, dr.kareem215@yahoo.com

Received Date: June 17, 2025

Accepted Date: October 21, 2025

Citation:

Mahmoud K, Hasan W, Taha H, ElRemisy D. Allopurinol for Prevention of Contrast-induced Acute Kidney Injury in Patients Undergoing Percutaneous Coronary Intervention: A Randomized-controlled Trial. J Clin Cardiol. 2025;6(2):133–141.


Copyright: © 2025 Mahmoud K, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Abstract

Background: Contrast-induced acute kidney injury (CI-AKI) is a potential complication following percutaneous coronary intervention (PCI), particularly in patients with pre-existing kidney conditions. Previous research has identified hyperuricemia as a predictor for CI-AKI. Allopurinol, a medication commonly used to manage hyperuricemia, also possesses anti-inflammatory properties. This study aims to assess the impact of adding allopurinol to hydration therapy on CI-AKI incidence in patients undergoing PCI.

Results: We enrolled 107 patients undergoing PCI with moderate to high Mehran risk scores; Participants were randomly assigned to either an allopurinol group (n=52) or a control group (n=55). The allopurinol group received 300 mg of allopurinol 24 hours before and one hour before PCI, along with intravenous normal saline at 1 ml/kg/hour. The control group received conventional hydration only. Serum creatinine and urea levels were measured before and 48 hours after the procedure. An increase in serum creatinine by ≥25% or ≥0.5 mg/dL 48 hours after PCI was used to detect contrast-induced acute kidney injury (CI-AKI).
The mean age of the patients was 59.8±8.9 years, with 63% being male. The baseline Mehran risk score was 9.5±3.0. Baseline characteristics, including age, gender, risk factors, kidney function, and uric acid levels, were similar between the two groups. CI-AKI occurred in 5 patients (9.6%) in the allopurinol group and 15 patients (27.3%) in the control group (P=0.017). No significant difference was found in serum uric acid levels between patients with and without CI-AKI (7.2±2.8 mg/dL vs. 6.8±2.0 mg/dL, p-value: 0.49).

Conclusion: Our results suggest that allopurinol may reduce CI-AKI incidence beyond its hypouricemic effect following elective PCI in patients with moderate to high Mehran risk score. However, further large-scale, multi-center studies are needed to confirm these findings.

Keywords

Allopurinol, Contrast-induced acute kidney injury, Coronary artery disease, Percutaneous coronary intervention

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