Angiographically induced renal failure and its radiographic detection

Decreased renal function following arteriography is much more common than is currently realized. Steps to detect this failure are necessary, especially in high risk patients, so that stressful situations such as surgery can be avoided. A recently performed prospective random study of 100 patients undergoing angiography demonstrated a 10% incidence of renal failure. Those patients most at risk had preexisting renal disease as indicated by an elevated serum creatinine and/or cardiovascular disease severe enough to require digoxin, diuretics, or nitroglycerin. No cases of renal failure occurred in the absence of one or both of these processes. The likelihood of postangiographic renal failure was unrelated to the quantity of contrast as measured either by total volume or per kilogram body weight.