Grant: Project Grant

To diagnose and treat blockages in the arteries of the heart, a cardiac catheterization with the injection of an iodine dye is often indicated. However, this dye can be toxic for the kidneys and can lead to renal complications, hemodialysis, and additional cardiac events. To prevent these complications, doctors administer intravenous fluids during and after the procedure, but the most effective and safer quantity to use is unknown. Giving too much fluid can cause heart failure, but administering too little may not be sufficient to prevent renal complications. Adjusting the amount of fluid based on key individual patients' characteristics could be more effective than the standard strategy of using a fixed, non-personalized amount. In this study, patients undergoing a cardiac catheterization will be divided randomly into two groups. In the first group, the quantity of fluid will be adjusted to ensure that the participants who are at the highest risk of developing renal complications (those with low intra-cardiac pressure, poor renal function, and a high quantity of dye administered) will receive a larger amount of fluid, and that those with a lower risk of renal complications will receive a lower amount of fluid. In the second group, participants will receive a fixed quantity of fluid, as we usually do in routine clinical practice. Renal and cardiac complications will be evaluated at 48 hours, 7 days, and 6 months with a blood test and a call from the study team. We believe that, with the novel personalized hydration strategy, the risk of renal and cardiac complications will be decreased compared to what is usually done in routine clinical practice. Given the fact that heart diseases are the most common cause of death and disability in Canada, and that cardiac catheterization is a commonly performed procedure in patients with heart disease, this study has the potential to improve patient care at a large scale using a simple, safe, and low-cost novel strategy.