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Effects of a High Dose of the Contrast Medium Iodixanol on Renal Function in Patients Following Percutaneous Coronary
Ning Zhao1, Zaiyan Chen1, Yinpin Zhou2
1Institution of Cardiovascular Research, Xinqiao Hospital, 105785Third Military Medical University (Army Medical University), Chongqing, China.
Insights
High-dose iodixanol use in percutaneous coronary intervention (PCI) showed low rates of contrast-induced acute kidney injury (CI-AKI). Contrast volume was not a significant predictor of CI-AKI in this study.
Area of Science:
- Nephrology
- Cardiology
- Radiology
Background:
- Iodixanol is recognized for its association with reduced contrast-induced acute kidney injury (CI-AKI).
- The impact of substantial iodixanol volumes on renal function post-percutaneous coronary intervention (PCI) requires further investigation.
Purpose of the Study:
- To assess the renal effects of high-dose iodixanol (>300 mL) within 72 hours following PCI.
- To identify independent predictors of CI-AKI in patients receiving high-dose iodixanol during PCI.
Main Methods:
- Retrospective review of 676 patients undergoing PCI with high-dose iodixanol (>300 mL) from October 2015 to December 2017 across four centers.
- Logistic regression analysis was employed to determine significant risk factors for CI-AKI.
Main Results:
- The overall incidence of CI-AKI was 3.5%.
- Incidence rates were 3.9% for 300-500 mL and 1.7% for >500 mL iodixanol.
- Independent predictors for CI-AKI included female sex, chronic kidney disease, and baseline estimated glomerular filtration rate (eGFR), but not contrast volume.
Conclusions:
- High-dose iodixanol administration (>300 mL) during PCI is associated with low CI-AKI rates.
- Contrast volume itself was not an independent risk factor for CI-AKI in this patient cohort.
Abstract:
Iodixanol is associated with lower rates of contrast-induced acute kidney injury (CI-AKI). However, the effects of high volumes of iodixanol on renal function after percutaneous coronary intervention (PCI) have not been fully elucidated. This study evaluates the effects of high-dose (>300 mL) iodixanol on renal function within 72 hours of PCI. We retrospectively reviewed 676 consecutive patients who received high-dose (>300 mL) iodixanol during PCI between October 2015 and December 2017 in 4 centers. Logistic regression analysis was used to identify significant independent predictors for CI-AKI. The incidence of CI-AKI was 3.5% (23/651). In patients administered 300 to 500 mL and >500 mL iodixanol, the incidence of CI-AKI was 3.9% and 1.7%, respectively. In patients with an estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m2, the incidence of CI-AKI was 2.6%. In high-risk and very high-risk patients, stratified by the Mehran risk score, the incidence of CI-AKI was 3.3% and 4.3%, respectively. In patients received high-dose iodixanol (>300 mL), logistic regression analysis demonstrated that female sex, chronic kidney disease, and eGFR were independent risk factors for CI-AKI, but contrast volume was not. The administration of high (300-500 mL) and very high (>500 mL) dose of iodixanol is associated with low rates of CI-AKI.
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