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When Prevention is Truly Better than Cure: Contrast-Associated Acute Kidney Injury in Percutaneous Coronary

Tea Isaac1, Salima Gilani1, Neal S Kleiman1

  • 1Houston Methodist DeBakey Heart & Vascular Center, Houston Methodist Hospital, Houston, Texas, US.

Methodist Debakey Cardiovascular Journal
|September 22, 2022
PubMed

Insights

Preventing contrast-associated acute kidney injury (CA-AKI) is crucial, especially for patients with chronic kidney disease (CKD). This review details evidence-based strategies to minimize CA-AKI risk during percutaneous coronary intervention (PCI).

Area of Science:

  • Nephrology
  • Cardiology
  • Interventional Cardiology

Background:

  • Contrast-associated acute kidney injury (CA-AKI) is a common complication following cardiovascular angiography and percutaneous coronary intervention (PCI).
  • Patients with advanced chronic kidney disease (CKD) face a significantly elevated risk of developing CA-AKI.
  • CA-AKI is associated with substantial morbidity and mortality, making prevention paramount.

Purpose of the Study:

  • To provide a clinically focused review of current strategies for preventing CA-AKI in patients undergoing PCI.
  • To highlight evidence-based pre-procedural and peri-procedural interventions to mitigate CA-AKI risk.
  • To emphasize the importance of implementing care bundles for improved patient outcomes.

Main Methods:

  • Review of recent literature on CA-AKI prevention strategies.
  • Appraisal of pre-procedural and peri-procedural measures.
  • Focus on evidence-based care bundles for PCI patients.

Main Results:

  • Identification of key strategies to minimize CA-AKI risk.
  • Emphasis on the effectiveness of implementing comprehensive care bundles.
  • Demonstration of improved outcomes in vulnerable patient populations.

Conclusions:

  • Proactive prevention is the primary approach to managing CA-AKI.
  • Evidence-based care bundles are effective in reducing CA-AKI incidence.
  • Widespread adoption of these strategies can significantly improve outcomes for PCI patients at risk.

Keywords:
acute kidney injurycardiogenic shockcontrast associated kidney injurycontrast induced nephropathycoronary artery diseasepercutaneous coronary intervention

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