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Prophylactic hydration to protect renal function from intravascular iodinated contrast material in patients at high risk of contrast-induced nephropathy (AMACING): a prospective, randomised, phase 3, controlled, open-label, non-inferiority trial.

Journal Club Summary

Methodology Score: 3/5                   
Usefulness Score:  3.5/5
Nijssen EC, et al
Lancet. 2017 Feb 20. [Epub ahead of print]

This prospective, open-label, single centre, randomized trial of 660 patients found no hydration (2.7% incidence CIN) to be non-inferior compared to iv hydration (2.6% incidence CIN) in preventing contrast induced nephropathy in patients with reduced renal function undergoing elective procedures requiring contrast; there were no related deaths and no patients required haemodialysis within 35 days. While the study excluded patients with eGFR<30 and ER patients, the results are reassuring and will be helpful in shared decision making with patients and our radiology colleagues. 
By: Dr. Rebecca Brown

 Epi lesson

The purpose of randomization is to minimize imbalance between groups. Sometimes, we know certain factors are likely to influence outcomes and ought to be equally distributed (e.g. male, female). A strategy to ensure this stratifies participants according to important factors, then uses separate randomization lists for each sub-groups. This becomes impractical when a large number of factors need to be taken into account. Minimization calculates the imbalance between groups that would result from a particular assignment, and uses a strategy favoring assignment to the group that would minimize this imbalance between comparison groups.

By: Dr. Christian Vaillancourt  


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