Contrast-induced nephropathy following chronic total occlusion percutaneous coronary intervention in patients with

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A Large Animal Model for Acute Kidney Injury by Temporary Bilateral Renal Artery Occlusion

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Yuan-Hui Liu1, Yong Liu, Ning Tan

  • 1Southern Medical University, Guangzhou, 510515, Guangdong, China.

European Radiology
|May 19, 2015
PubMed

Insights

Attempting percutaneous coronary intervention for chronic total occlusion in patients with chronic kidney disease may not increase the risk of contrast-induced nephropathy. Careful preventative measures are key to managing this risk in high-risk patients.

Area of Science:

  • Cardiology
  • Nephrology
  • Interventional Cardiology

Background:

  • Contrast-induced nephropathy (CIN) is a significant complication following percutaneous coronary intervention (PCI).
  • Patients with chronic kidney disease (CKD) are at elevated risk for CIN.
  • The specific risk of CIN in CKD patients undergoing PCI for chronic total occlusion (CTO) remains understudied.

Purpose of the Study:

  • To investigate the incidence and risk of CIN in high-risk CKD patients undergoing PCI for CTO.
  • To compare CIN rates among CKD patients undergoing CTO-PCI, non-CTO PCI, and no PCI.

Main Methods:

  • A prospective observational study of 515 consecutive CKD patients undergoing PCI.
  • Patients were categorized into three groups: attempted CTO-PCI (Group A), non-CTO PCI (Group B), and no PCI (Group C).
  • CIN incidence, contrast media dose, hydration volume, and clinical outcomes were analyzed.

Main Results:

  • The overall incidence of CIN was 10.68%.
  • Group A (CTO-PCI) received a higher contrast media dose (p=0.024).
  • No significant difference in CIN incidence (Group A: 9.4%, Group B: 6.7%, Group C: 11.4%; p=0.344) or outcomes was observed between groups after multivariate analysis.

Conclusions:

  • Attempting CTO-PCI in CKD patients does not appear to significantly increase CIN risk when appropriate preventative strategies are employed.
  • The study highlights the importance of preventative measures in managing CIN risk in this vulnerable population.
  • Further research may focus on optimizing preventative protocols for CTO-PCI in CKD patients.
Abstract

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