Contrast-induced nephropathy in patients with chronic kidney disease and peripheral arterial disease. (24th June 2015)

• Record Type: Journal Article
• Authors: Kroneberger, Christian; Enzweiler, Christian N; Schmidt-Lucke, Andre; Rückert, Ralph-Ingo; Teichgräber, Ulf; Franiel, Tobias
• Is Part Of: Acta radiologica open. Volume 4:Number 6(2015)
• Publication Date: 2015-06-24
• Subjects: Contrast-induced nephropathy (CIN) -- peripheral arterial disease (PAD) -- chronic kidney disease (CDK) -- estimated glomerular filtration rate (eGFR); Radiology -- Periodicals; Diagnostic Imaging -- Periodicals; Radiology; Periodicals; 616.075705
• DOI: 10.1177/2058460115583034
• Languages: English
• ISSNs: 2058-4601

Abstract

Background: The risk for contrast-induced nephropathy (CIN) after intra-arterial application of an iodine-based contrast material is unknown for patients with chronic kidney disease (CKD) and peripheral arterial disease (PAD). Purpose: To investigate the incidence of CIN in patients with CKD and PAD. Material and Methods: This retrospective study was approved by the local ethics committee. One hundred and twenty patients with 128 procedures (73 with baseline eGFR in the range of 45–60 mL/min/1.73m 2, 55 with eGFR < 45 mL/min/1.73m 2 ) were evaluated. All patients received intra-arterially an iodine-based low-osmolar contrast material (CM) after adequate intravenous hydration with isotonic NaCl 0.9% solution. CIN was defined as an increase in serum creatinine of more than 44 μmol/L within 4 days. The influence of patient-related risk factors (age, weight, body mass index, eGFR, serum creatinine, hypertension, diabetes mellitus, coronary heart disease, heart failure) and therapy-related risk factors (amount of CM, nephrotoxic drugs, number of CM applications) on CIN were examined. Results: CIN developed in 0% (0/73) of procedures in patients with PAD and an eGFR in the range of 45–60 mL/min/1.73m 2 and in 10.9% (6/55) of procedures in patients with an eGFR <45 mL/min/1.73m 2 . No risk factor significantly influenced the development of CIN, although baseline serum creatinine ( P = 0.06) and baseline eGFR ( P = 0.10) showed a considerable dependency. Conclusion: Patients with an eGFR in the range of 45–60 mL/min/1.73m 2 and PAD seem not at risk for CIN after intra-arterial CM application and adequate hydration. Whereas, an eGFR < 45 mL/min/1.73m 2 correlated with a risk of 10.9% for a CIN.