Abstract: Objective To investigate the effect of intermittent venovenous hemofiltration (IVVH) for the prevention of contrast-induced acute kidney injury (CI-AKI) in elderly patients with chronic renal failure (CRF) as well as the current situation about this clinical issue. Methods A total of 39 elderly (≥60 years old) CRF patients treated with coronary angiography and /or percutaneous coronary intervention (PCI) in Beijing Hospital during the period from Jun. 2014 to Dec. 2015 were retrospectively studied. There were divided into IVVH group (with preventive IVVH after PCI) and non-IVVH group (without preventive IVVH after PCI). The prevalence of CI-AKI and its related clinical data were compared between the two groups. Results The average age was 74.03±7.65 years old in the 39 elderly CRF patients, of whom 18 were in the IVVH group and 21 in the non-IVVH group. In the 18 patients in IVVH group, the primary diseases for CRF were hypertensive nephropathy (n=8), diabetic nephropathy (n=3), ischemic nephropathy (n=2), and other renal diseases (n=5); before PCI, serum cretinine was 188.83 ± 76.68 mmol/l, and eGFR was 30.89±12.38 ml/(min·1.73m2); the average iodinated contrast agent used was 176.67±69.11ml; the parameters of IVVH used were blood flow rate 155.56±9.84 ml/min, hemofiltration fluid replacement rate 29.73±6.42 ml/(kg·h), and ultrafiltration volume 386.72 ±265.75 ml/time. The prevalence of CI-AKI was 5.56% in IVVH group and was 42.86% in non- IVVH group (χ2=5.252, P=0.022). Conclusions Preventive IVVH after PCI is probably an effective measure to reduce the prevalence of CI-AKI in elderly patients with chronic renal failure.

Key words: chronic renal failure, contrast-induced acute kidney injury,  Intermittent venovenous hemofiltration, prevention