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Effect of cardiac catheterization on renal function
1Department of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City.
Insights
This study found a low risk of kidney damage from radiocontrast agents in patients undergoing cardiac catheterization. Sensitive tests showed no significant change in renal function, indicating safety for low-risk individuals.
Area of Science:
- Nephrology
- Cardiology
- Radiology
Background:
- Radiocontrast agents are frequently used in cardiac catheterization.
- Nephrotoxicity is a potential complication, particularly in at-risk patients.
- Assessing renal function changes requires sensitive methodologies.
Purpose of the Study:
- To investigate the incidence of radiocontrast-induced nephrotoxicity.
- To evaluate changes in renal function after cardiac catheterization using sensitive methods.
- To identify risk factors for contrast-induced nephrotoxicity.
Main Methods:
- Utilized sensitive acute renal clearance methodology.
- Measured creatinine clearance before and after cardiac catheterization in 23 low-risk patients.
- Calculated creatinine clearance from four consecutive 30-minute renal clearance periods.
Main Results:
- No significant change in creatinine clearance was observed post-procedure (101.5 +/- 6.4 ml/min pre vs. 111.6 +/- 7.4 ml/min post).
- Only one patient (4.3%) experienced a decrease in creatinine clearance exceeding 25%.
- Patient age, diabetes, and contrast volume were not identified as adverse risk factors.
Conclusions:
- Elective cardiac catheterization poses a low risk of nephrotoxicity in low-risk patients.
- Sensitive measures of glomerular filtration rate confirm minimal impact on renal function.
- Current protocols appear safe for this patient population regarding contrast-induced kidney injury.
Abstract:
Sensitive acute renal clearance methodology was used to investigate the incidence of radiocontrast-induced nephrotoxicity in patients undergoing cardiac catheterization. Patients at the University of Oklahoma Teaching Hospitals scheduled for elective cardiac catheterization had their creatinine clearance measured on the day preceding and the day following their procedure. All patients had a serum creatinine concentration lower than 175 mumol/l. The creatinine clearance was calculated from the mean of four consecutive 30-minute renal clearance periods obtained in the fasted state during water loading. The change in renal function following the catheterization was evaluated. There was no significant change in the creatinine clearance after the cardiac catheterization (Ccr 101.5 +/- 6.4 ml/min before and 111.6 +/- 7.4 ml/min after the procedure). A decrease in Ccr exceeding 25% occurred in 1 of 23 subjects (4.3%. Patient age, presence of diabetes, and volume of contrast agent were not adverse risk factors. The results suggest a low risk of nephrotoxicity in low-risk patients undergoing elective cardiac catheterization, even when very sensitive measures of glomerular filtration rate are utilized.