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A Study of Estimated Glomerular Filtration Rate in Patients Undergoing Diagnostic or Interventional Coronary Contrast

Mohammed Shoeb A Khan1, K Vinod Kumar1, R Anil Kumar2

  • 1Department of Nephrology, Aster Medcity, Kochi, Kerala, India.

Indian Journal of Nephrology
|May 23, 2022
PubMed

Insights

Contrast-induced acute kidney injury (CI-AKI) occurred in 23.4% of chronic kidney disease (CKD) patients undergoing coronary procedures. However, CI-AKI was self-limiting and did not significantly impact estimated glomerular filtration rate (eGFR) at 3 months.

Area of Science:

  • Nephrology
  • Cardiology
  • Radiology

Background:

  • Angiographic procedures are underutilized in chronic kidney disease (CKD) patients with acute coronary syndromes due to the risk of contrast-induced acute kidney injury (CI-AKI).
  • Assessing the impact of CI-AKI on kidney function is crucial for managing CKD patients undergoing cardiovascular interventions.

Purpose of the Study:

  • To evaluate the change in estimated glomerular filtration rate (eGFR) over 3 months in CKD patients following coronary procedures.
  • To determine the incidence and effects of CI-AKI in this high-risk population.

Main Methods:

  • An observational study included 282 CKD patients (eGFR <60 mL/min/1.73 m²).
  • eGFR was calculated using the CKD-EPI equation pre-procedure and at 24, 48, 72 hours, and 30, 90 days post-procedure.
  • CI-AKI prophylaxis followed KDIGO guidelines.

Main Results:

  • CI-AKI developed in 66 (23.4%) patients, with incidence increasing with CKD severity.
  • Mean contrast volume was 55.17 mL for coronary angiogram and 156.94 mL for percutaneous transluminal coronary angioplasty.
  • No significant change in eGFR was observed at 1 and 3 months post-procedure, even in patients who developed CI-AKI.

Conclusions:

  • CI-AKI in CKD patients undergoing coronary procedures is generally self-limiting.
  • The condition does not appear to have major detrimental effects on long-term eGFR at 3 months post-contrast exposure.
Abstract

Keywords:
AKIcontrastcoronary procedureeGFR

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