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Ultra-Low Contrast Volume for Patients with Advanced Chronic Kidney Disease Undergoing Coronary Procedures

Zach Rozenbaum1,2, Sydney Benchetrit3,2, Eliezer Rozenbaum4,2

  • 1Department of Cardiology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.

Nephron
|February 3, 2018
PubMed

Insights

Ultra-low contrast volume coronary procedures are safe for patients with advanced chronic kidney disease. This technique effectively preserves renal function and may increase percutaneous coronary intervention use in high-risk patients.

Area of Science:

  • Cardiology
  • Nephrology
  • Interventional Cardiology

Background:

  • Contrast-induced nephropathy (CIN) poses risks for patients undergoing coronary interventions, especially those with advanced chronic kidney disease.
  • Adverse clinical outcomes are linked to CIN in this vulnerable patient population.

Purpose of the Study:

  • To evaluate the feasibility and safety of using ultra-low contrast volumes in coronary procedures for patients with advanced chronic kidney disease.
  • To assess the impact of this technique on renal function in high-risk patients.

Main Methods:

  • A prospective study included 30 patients with an estimated glomerular filtration rate (eGFR) <45 mL/min/1.73 m2.
  • Coronary procedures were performed utilizing an ultra-low contrast volume technique.

Main Results:

  • The median contrast volume used was 13 mL for diagnostic angiography and 13 mL for percutaneous coronary intervention (PCI).
  • Only 10% of patients showed a ≥25% increase in serum cystatin C; none had a ≥25% increase in serum creatinine at 48 hours.
  • No patient required renal replacement therapy or unplanned coronary intervention within 6 months post-procedure.

Conclusions:

  • The ultra-low contrast technique is feasible, safe, and effective in patients with advanced chronic kidney disease, without significant renal function decline.
  • This approach may enhance the use of PCI in high-risk coronary patients with chronic kidney disease.
Abstract

Keywords:
Chronic kidney diseaseContrast-induced nephropathyCoronary artery disease

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