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Effect of Theophylline on Contrast Material–induced Nephropathy in Patients with Chronic Renal Insufficiency: Controlled, Randomized, Double-blinded Study¹

Wolfgang Huber, MD, Kathrin Ilgmann, Michael Page, PhD, Michael Hennig, Dipl Stat, Ursula Schweigart, MD, Barbara Jeschke, MD, Leopoldo Lutilsky, MD, Wolfgang Weiss, MD, Hermann Salmhofer, MD and Meinhard Classen, MD

¹ From the II. Medizinische Klinik, Klinische Chemie (W.H., K.I., M.P., U.S., B.J., H.S., M.C.); Institut für Medizinische Statistik und Epidemiologie (M.H.), I. Medizinische Klinik (L.L.), and Department of Radiology (W.W.), Klinikum Rechts der Isar, Technical University of Munich, Ismaningerstrasse 22, Station 2/11, D-81675 Munich, Germany. Received March 17, 2001; revision requested April 30; final revision received November 7; accepted December 6. Address correspondence to W.H. (e-mail: wolfgg.huber@t-online.de).
² Dr Schweigart died in April 2000.

View larger version (27K): [in a new window]   Figure 1. Graph shows the number of patients with different amounts of contrast medium in the placebo and theophylline groups. There were no significant differences between groups (P > .05 for all comparisons, 2 test).

View larger version (46K): [in a new window]   Figure 2. Graph shows the time course of serum creatinine in patients with contrast medium (CM)-induced nephropathy (patients 1-8, placebo; patients 9 and 10, theophylline; see Table 3). * = serum creatinine level on day of discharge exceeded baseline value by less than 0.5 mg/dL; ** = serum creatinine level on day of discharge exceeded baseline value greater than or equal to 0.5 mg/dL. (To convert serum creatinine values to micromoles per liter, multiply by 88.4.)

View larger version (32K): [in a new window]   Figure 3. Graph shows differences in serum creatinine level at different times after contrast medium administration, as compared with that at baseline. An increase in serum creatinine level over time, as compared with baseline levels, results in a positive difference and a boxplot that is elevated above the zero line. P values are indicated only when P is less than .05 (Wilcoxon paired test). Boxplot shows median (thick horizontal lines in boxes) and quartiles. Whiskers extend to the most extreme observations that are not more than 1.5 x interquartile range (IQR) beyond the quartiles. Observations beyond the whiskers are plotted individually. = greater than 1.5 x IQR beyond the quartiles; x = greater than 3.0 x IQR beyond the quartiles; solid box = 12 hours to baseline; cross-hatched boxes = 24 hours to baseline; boxes with diagonal lines = 48 hours to baseline. (To convert serum creatinine values to micromoles per liter, multiply by 88.4).

View larger version (30K): [in a new window]   Figure 4. Graph shows differences in urinary excretion of ß-NAG at different times after contrast medium administration, as compared with that at baseline. An increase in ß-NAG over time, as compared with baseline levels, results in a positive difference and a boxplot elevated above the zero line. P values are indicated only when P is less than .05 (Wilcoxon paired test). Boxplot shows location of median (thick horizontal lines in boxes) and quartiles. Whiskers extend to most extreme observations not more than 1.5 x IQR beyond the quartiles. Observations beyond whiskers are plotted individually ( = greater than 1.5 x IQR beyond the quartiles, x = greater than 3.0 x IQR beyond the quartiles, white box = 4 hours to baseline; cross-hatched box = 12 hours to baseline, box with diagonal lines = 24 hours to baseline). (To convert serum creatinine values to micromoles per liter, multiply by 88.4).