02092nas a2200241   4500000000100000008004100001100001400042700001300056700001700069700001600086700001300102700001300115700002000128700001200148700001700160700001400177700001400191245012600205300001600331490000600347520148300353022001401836       2018                            d1 aWang Ying1 aWang Kun1 aChen Shi-Qun1 aChen Ji-Yan1 aLiu Yong1 aTan Ning1 aDuan Chong-Yang1 aBei Wei1 aWu Deng-Xuan1 aChen Ping1 aLi Li-Wen00aOptimal hydration volume among high-risk patients with advanced congestive heart failure undergoing coronary angiography.  a23738-237480 v93 a<p>We investigated the relationship between weight-adjusted hydration volumes and the risk of developing contrast-induced acute kidney injury (CI-AKI) and worsening heart failure (WHF) and explored the relative safety of optimal hydration volumes in patients with advanced congestive heart failure (CHF) undergoing coronary angiography (CAG) or percutaneous coronary intervention. We included 551 patients with advanced CHF (New York Heart Association class > 2 or history of pulmonary edema) undergoing CAG (follow-up period 2.62 ± 0.9 years). There was a significant association between hydration volume-to-weight ratio (HV/W) (quintile Q1, Q2, Q3, Q4, and Q5) and the incidence of CI-AKI (3.7%, 14.6%, 14.3%, 21.1%, and 31.5%, respectively) and WHF (3.6%, 5.4%, 8.3%, 13.6%, and 19.1%, respectively) (all  < 0.001). Receiver operating curve analysis indicated that HV/W = 15 mL/kg and the mean HV/W (60.87% sensitivity and 64.96% specificity) were fair discriminators for CI-AKI (C-statistic 0.696). HV/W >15 mL/kg independently predicted CI-AKI (adjusted odds ratio [OR] 2.33;  = 0.016) and WHF (adjusted OR 2.13;  = 0.018). Moreover, both CI-AKI and WHF were independently associated with increased long-term mortality. Thus, for high-risk patients with advanced CHF undergoing CAG, HV/W > 15 mL/kg might be associated with an increased risk of developing CI-AKI and WHF. The potential benefits of a personalized limitation of hydration volume need further evaluation.</p>  a1949-2553