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4ditorial abc |
The present study [1] has a questionable ABC Cardio editorial profile and does not present any novelty. However, its publication decision would be useful for cardiologists in their preoperative control activity. Acute renal insufficiency (ARI) is always talked about, and sometimes people say that it is either being underestimated or overestimated. Many studies support alternative protocols to prevent contrast-induced nephropathy (CIN) caused by iodine contrasts. It is opportune mentioning the universal ambulatory vessels and heart exams carried out on the "cath-lab". These protocols include 1) Drugs; 2) alkalinization with sodium bicarbonate, and; 3) hydration. Among different drugs, nicorandil has been used in patients with chronic renal dysfunction. A trial performed to assess its preventive effect on high-risk patients revealed substantial efficacy over hydration protocol for cardiac catheterization. [2]. We agree with authors [1] that the most effective preventive measure to date is intravenous hydration (IVH). However, current evidence has shown that oral hydration (OH) is comparable to intravenous infusion. But the effectiveness of ambulatory oral hydration (OH) still needs more investigations in preventing CIN in elective coronary procedures. The present OH protocol performed by the patient appears to be like the hospital IVH protocol in the renal protection. The authors suggest testing it in large trials in an attempt to prove that OH is effective and would be useful in medical practice.
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