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Updated: Jan 19, 2026
Modeling Preservation Injury in Porcine Donor Kidney: A Procedure to Induce Graft Dysfunction by Subjecting Kidney to Prolonged Cold Ischemia
Zero-contrast percutaneous coronary interventions to preserve kidney function in patients with severe renal
Jerzy Sacha1,2, Marek Gierlotka1, Przemysław Lipski1
1Department of Cardiology, University Hospital, Faculty of Natural Sciences and Technology, University of Opole, Opole, Poland.
Insights
Zero-contrast percutaneous coronary intervention (zero-PCI) is a safe and effective method for preventing kidney damage in patients with chronic kidney disease (CKD). This technique shows promise for preserving renal function, even in complex cases.
Area of Science:
- Cardiology
- Nephrology
- Interventional Cardiology
Background:
- Zero-contrast percutaneous coronary intervention (zero-PCI) is emerging as a strategy to prevent contrast-induced acute kidney injury (AKI) in patients with chronic kidney disease (CKD).
- Existing evidence for zero-PCI's feasibility, safety, and clinical utility is primarily based on limited case reports or small patient series.
Purpose of the Study:
- To evaluate the outcomes of zero-PCI in patients with severe CKD, including those on hemodialysis, with the goal of preserving renal function.
- To assess the feasibility, safety, and mid-term clinical outcomes of zero-PCI in a cohort of patients with advanced CKD.
Main Methods:
- Twenty-nine zero-PCIs were performed in 20 patients with advanced CKD, often as staged procedures.
- The study included 4 hemodialysis patients who maintained residual renal function.
- The estimated median risk for contrast-induced AKI in non-dialysis patients was 26% (range: 26-57%).
Main Results:
- Zero-PCI was successfully performed in all intended patients, including those with complex coronary lesions (e.g., left main stenosis, saphenous vein graft lesions).
- No procedure-specific complications were observed. The actual incidence of AKI post-procedure was 10%, with no patient requiring renal replacement therapy.
- Three of the four hemodialysis patients retained their residual renal function. During a median follow-up of 3.2 months, no patient experienced acute coronary events or required revascularization.
Conclusions:
- Zero-PCI is a safe and promising interventional cardiology technique for preserving renal function in patients with CKD and those on hemodialysis.
- The procedure is feasible even for complex coronary anatomies, demonstrating good mid-term clinical outcomes.
- Zero-PCI represents a valuable option for managing coronary artery disease in renally compromised patients.
Introduction:
Zero-contrast percutaneous coronary intervention (zero-PCI) is a new method for prevention of contrast-induced acute kidney injury (AKI) in patients with chronic kidney disease (CKD). However, evidence for its feasibility, safety and clinical utility is limited to reports of single cases or series of patients.
Aim:
To present outcomes of zero-PCI in patients with severe CKD, including hemodialysis subjects, who were treated with this procedure in order to preserve their renal function.
Material And Methods:
Twenty-nine zero-PCIs were performed, mostly as a staged procedure, in 20 patients with advanced CKD. In this group, 4 patients were treated with hemodialysis but presented preserved residual renal function. The estimated median risk for contrast-induced AKI in non-dialysis patients was 26% (26-57%).
Results:
Zero-PCI was feasible in each intended patient, including those with complex left main stenosis or lesion within a saphenous vein graft, and there was no specific complication associated with this technique. After the procedure, the factual AKI prevalence was 10% and no patient required renal replacement therapy. Three of 4 hemodialysis patients preserved their residual renal function. During the median follow-up of 3.2 (1.2-5.3) months no patient experienced an acute coronary event or required revascularization.
Conclusions:
Zero-PCI is a safe and promising method to preserve renal function in patients with CKD and hemodialysis patients. Such an approach is feasible even in complex coronary lesions and yields good clinical outcomes in mid-term observation.
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