Protection of Radiocontrast Induced Nephropathy by Vitamin E (Alpha Tocopherol): A Randomized Controlled Pilot Study
Adis Tasanarong MD*, Dilok Piyayotai MD**, Supachai Thitiarchakul MD*
Affiliation : * Nephrology Unit, Department of Medicine, Faculty of Medicine, Thammasat University (Rangsit Campus), Pathumtani, Thailand ** Cardiology Unit, Department of Medicine, Faculty of Medicine, Thammasat University (Rangsit Campus), Pathumtani, Thailand
Background : Contrast-induced nephropathy (CIN) increases the likelihood of patient morbidity and
mortality following coronary procedures. Contrast agents cause an acute deterioration in renal function via
the generation of reactive oxygen species. The present study was designed to evaluate the administration of
antioxidant vitamin E (alpha tocopherol) as a means of preventing CIN in these patients.
Material and Method: The authors conducted a prospective, double-blind, randomized and placebo-
controlled trial in 103 patients with serum creatinine (SCr) levels > 1.2 mg/dL, baseline creatinine clearance
levels < 60 mL/min, and who had undergone coronary procedures. Alpha tocopherol (525 IU) or a placebo
compound was administered orally at 48 hr, 24 hr, and in the morning prior to coronary procedures.
Results : CIN developed in 3 of 51 patients (5.88%) in the alpha tocopherol group and 12 of 52 patients
(23.08%) in the placebo group (odds ratio [OR], 0.21; 95% confidence interval [CI], 0.05 to 0.79; p = 0.02).
The mean SCr increased significantly in the placebo group (from 1.67 + 0.53 to 1.9 + 0.87 mg/dL, p = 0.02)
but not in the alpha tocopherol group (from 1.62 + 0.44 to 1.64 + 0.59 mg/dL, p = 0.74). Patients with
diabetes, anemia, or with contrast agent dosages greater than 120 ml exhibited significantly lower incidences
of CIN development in the alpha tocopherol group than the placebo group (p < 0.05).
Conclusion : Prophylactic oral administration of alpha tocopherol is capable of protecting against CIN in
patients with chronic kidney disease undergoing elective coronary procedures.
Keywords : Alpha-Tocopherol, Vitamin E, Contrast induced nephropathy (CIN), Coronary procedures
