The Role Of Colchicine In Preventing Contrast-Induced Acute Kidney Injury In Patients Undergoing Elective Percutaneous Coronary Intervention

BACKGROUND: Contrast induced acute kidney injury (CI-AKI) is a serious complication of percutaneous coronary interventions (PCI) and is associated with increased morbidity and mortality. The aim of this study was to investigate the preventive role of colchicine on CI-AKI in patients undergoing elective PCI considering to its anti-inflammatory and renoprotective effects.METHODS: This study was designed as a single-centered, randomized, and open-label study including 280 patients undergoing elective PCI with an estimated glomerular filtration rate (eGFR) of >45 mL/min/1.73 m(2). One-hundred-forty patients were randomized to the colchicine treatment group (mean age, 60 +/- 9 years), whereas 140 patients were randomized to the control group (mean age, 61 +/- 7 years). CI-AKI was defined as either a 50% relative increase in serum creatinine levels from the baseline or a 0.3 mg/dL increase in the absolute value that measured 48 h after PCI. Colchicine treatment was started 24 hours before the PCI and continued 48 hours after PCI. Logistic regression analysis was performed to identify the independent predictors of CI-AKI.RESULTS: CI-AKI occurred in 6 of the 140 patients (4%) in the colchicine group and in 13 of the 140 patients (9%) in the control group (odds ratio [OR]: 0.42; 95% confidence interval [CI]: 0.20 to 0.82; P=0.02). In patients under colchicine treatment, the rate of eGFR reduction after PCI was significantly lower than in that in those not under colchicine treatment (69 +/- 13 vs. 66 +/- 15, P=0.227; 72 +/- 11 vs. 63 +/- 13 P<0.001). In logistic regression analysis, age (OR=1.3, 95% CI: 1.1-1.6, P=0.005), diabetes mellitus (OR=2.24 95% CI: 1.17-3.31, P<0.001) and colchicine treatment (OR=0.84, 95% CI: 0.72-0.98, P=0.020) were independent predictors of CI-AKI.CONCLUSIONS: Prophylactic oral administration of colchicine may protect against CI-AKI in patients undergoing elective PCI with mildly or moderately decreased eGFR values.