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Does contrast media volume affect long-term survival in patients with chronic kidney disease?

Ismail Biyik1, Fatih Uzun2, Mehmet Erturk2

  • 1Department of Cardiology, Usak University, School of Medicine, Usak, Turkey.

Archives of Medical Sciences. Atherosclerotic Diseases
|December 16, 2017
PubMed

Insights

This study found that older age, higher contrast media volume, and lower estimated glomerular filtration rate (e-GFR) predict mortality in chronic kidney disease patients undergoing cardiac procedures. Lower use of angiotensin II receptor blockers (ARBs) also increased mortality risk.

Area of Science:

  • Nephrology
  • Cardiology
  • Medical Imaging

Background:

  • Patients with chronic kidney disease (CKD) are at increased risk during cardiac procedures.
  • Cardiac catheterization and coronary angiography are common diagnostic procedures for cardiovascular conditions.
  • Understanding survival predictors in CKD patients undergoing these procedures is crucial for risk stratification and management.

Purpose of the Study:

  • To investigate the relationship between survival and various clinical features in CKD patients undergoing cardiac catheterization and coronary angiography.
  • To identify independent predictors of long-term all-cause mortality in this high-risk population.

Main Methods:

  • A cohort of 307 consecutive patients with an estimated glomerular filtration rate (e-GFR) < 60 ml/min/1.73 m2 undergoing coronary angiography was studied.
  • Patients were followed for a median duration of 41.5 months.
  • Cox proportional hazards regression models were used to identify independent predictors of mortality.

Main Results:

  • Independent predictors of long-term all-cause mortality included older age (HR=1.047), higher contrast media volume (HR=1.004), lower e-GFR (HR=0.978), and lower angiotensin II receptor blocker (ARB) use (HR=0.485).
  • Patients receiving > 140 ml of contrast media had a significantly higher mortality rate (11.6%) compared to those receiving ≤ 140 ml (3.6%) (log-rank p=0.001).
  • The p-value for e-GFR was 0.04, indicating it was a significant predictor.

Conclusions:

  • Age, contrast media volume, e-GFR, and low ARB use are independent predictors of long-term mortality in CKD patients undergoing cardiac catheterization.
  • Using more than 140 ml of contrast media during cardiac catheterization is independently associated with increased long-term all-cause mortality.
  • These findings highlight the importance of minimizing contrast media exposure and optimizing medical therapy in CKD patients undergoing angiography.
Abstract

Keywords:
chronic kidney diseasecontrast media volumecoronary angiographymortality

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