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Contrast nephropathy post cardiac resynchronization therapy: an under-recognized complication with important
Peter J Cowburn1, Harshna Patel, Rebecca R Pipes
1Mount Sinai Hospital, 600 University Avenue, Suite 1609, Toronto, Ontario, Canada, M5G 1X5.
European Journal of Heart Failure
|May 28, 2005
Summary
Contrast nephropathy, a kidney complication, affects 14% of patients after cardiac resynchronization therapy (CRT). This under-recognized risk increases morbidity, mortality, and hospital stays, requiring greater patient and physician awareness.
Area of Science:
- Cardiology
- Nephrology
- Medical Complications
Background:
- Cardiac resynchronization therapy (CRT) is an advanced treatment for heart failure.
- CRT procedures are technically complex and carry inherent risks.
- Contrast nephropathy is a known complication of angiography but not previously described after CRT.
Purpose of the Study:
- To determine the incidence of contrast nephropathy in patients undergoing CRT.
- To identify risk factors and outcomes associated with contrast nephropathy post-CRT.
Main Methods:
- Retrospective chart review of patients who underwent CRT at a tertiary referral center.
- Contrast nephropathy defined as a ≥25% increase in serum creatinine within 48 hours of contrast administration.
Main Results:
- 14% (10 of 68 patients) developed contrast nephropathy.
- Pre-existing elevated creatinine (≥200 µmol/L) was associated with higher risk (43% vs. 7%).
- Contrast nephropathy led to significantly longer hospital stays (19 days vs. 4 days).
Conclusions:
- Contrast nephropathy is a frequent and under-recognized complication of CRT.
- This complication is associated with significant morbidity, mortality, and increased healthcare costs.
- Increased awareness among patients and physicians regarding this risk is crucial.