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Canadian-Italian randomized controlled trial for the prevention of contrast nephropathy


Iodinated radio-contrast media are the third most common reason for acute renal failure in hospitals (contrast nephropathy). Contrast nephropathy is mostly limited and transient, but a fraction of cases are severe enough to require dialysis, some do not re cover kidney function, while hospital stay, costs and mortality rates are all increased. To date there is no therapy for established cases.

However, the likelihood of developing contrast nephropathy is strongly linked to a number of identifiable risk factors, with reduced pre-existing kidney function being one of the most consistent. Given that administration of contrast is a predictable event that may precipitate acute renal failure, considerable research in animals and humans has focused on preventive therapies. Unfortunately many of the human trials testing the effect of fluid administration and antioxidant substances have provided not definitive or inconsistent results.

The purpose of the present project is to conduct a multi-centre international randomised controlled trial on the effect of potentially preventive measures on the occurrence of contrast nephropathy in subjects at risk. In the outgoing phase of the fellowship the applicant will be involved in the Canadian study, whereas in the return phase h e will lead and complete the multi-centre study in Italy. More generally, the aim is to increase the feasibility and the number of randomised clinical trials in hospital nephrology units in Italy, increasing the quality of research activity in the context of the Lombardy Registry of Dialysis and Transplantation.

To enhance the chance of success, we propose that the EU researcher applying to the OIF, be trained in a worldwide leading centre. The researcher will be trained on study design and methodology, and develop research skills lasting through his career on analysis of elements that come into play when trying to make changes in health care.

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