Related Experiment Video

Updated: Aug 7, 2025

A Large Animal Model for Acute Kidney Injury by Temporary Bilateral Renal Artery Occlusion
09:02

A Large Animal Model for Acute Kidney Injury by Temporary Bilateral Renal Artery Occlusion

Published on: February 2, 2021

4.5K

Contrast-Associated Acute Kidney Injury in High-Risk Patients Undergoing Peripheral Vascular Interventions

Satinderjit Locham1, Alejandra Rodriguez2, Mark D Balceniuk1

  • 1Division of Vascular Surgery, Department of Surgery, University of Rochester Medical Center, Rochester, NY, USA.

Vascular and Endovascular Surgery
|March 7, 2023
PubMed

Insights

Prophylactic intravenous hydration and CO2 angiography did not reduce contrast-associated acute kidney injury (CA-AKI) in high-risk patients undergoing peripheral vascular interventions. Reduced kidney function and diabetes are key predictors of CA-AKI.

Area of Science:

  • Nephrology
  • Cardiovascular Interventions
  • Radiology

Background:

  • Contrast-associated acute kidney injury (CA-AKI) is a significant complication in patients undergoing peripheral vascular interventions (PVI).
  • High-risk patients, particularly those with chronic kidney disease (CKD), are more susceptible to CA-AKI.
  • Prophylactic strategies like intravenous hydration (IV prophylaxis) and carbon dioxide (CO2) angiography are explored to mitigate renal injury.

Purpose of the Study:

  • To evaluate the efficacy of prophylactic IV hydration and CO2 angiography in preventing CA-AKI in high-risk patients undergoing PVI.
  • To determine the incidence and identify risk factors for CA-AKI in this patient population.

Main Methods:

  • Retrospective analysis of 4497 patients with CKD stage 3-5 undergoing elective PVI from 2017-2021, using the Vascular Quality Initiative (VQI) database.
  • Patients were categorized into groups receiving IV prophylaxis versus no prophylaxis.
  • CA-AKI was defined as a creatinine rise >0.5 mg/dL or new dialysis within 48 hours; logistic regression was used for analysis.

Main Results:

  • The overall incidence of CA-AKI was 0.93%.
  • Neither IV prophylaxis nor CO2 angiography showed a significant reduction in CA-AKI compared to no prophylaxis.
  • Severity of CKD and diabetes were identified as independent predictors of CA-AKI. Patients with CA-AKI faced significantly higher 30-day mortality and cardiopulmonary complications.

Conclusions:

  • Prophylactic IV hydration and CO2 angiography do not appear to reduce renal injury in high-risk CKD patients undergoing PVI.
  • Reduced kidney function and a history of diabetes are significant predictors of CA-AKI.
  • Development of post-procedural AKI is associated with substantially increased morbidity and mortality risk.

Keywords:
CO2 angiographyIV hydrationcontrast-associated acute kidney injurycontrast-induced acute kidney injurycontrast-induced nephropathyvascular access

More Related Videos

Technical Refinement of a Bilateral Renal Ischemia-Reperfusion Mouse Model for Acute Kidney Injury Research03:13

Technical Refinement of a Bilateral Renal Ischemia-Reperfusion Mouse Model for Acute Kidney Injury Research

Published on: November 3, 2023

2.3K
Use of a Hanging-weight System for Isolated Renal Artery Occlusion07:54

Use of a Hanging-weight System for Isolated Renal Artery Occlusion

Published on: July 19, 2011

16.1K

Related Concept Videos

Acute Kidney Injury IV: Diagnostic Studies and Prevention01:30

Acute Kidney Injury IV: Diagnostic Studies and Prevention

Accurate diagnosis and effective prevention are critical in managing Acute Kidney Injury (AKI), which is linked to high mortality rates ranging from 10% to 80%. Timely recognition of at-risk patients and careful monitoring can significantly reduce the likelihood of kidney damage.Diagnostic Assessments:The diagnostic process starts with a comprehensive medical history to identify prerenal, intrarenal, and postrenal causes.Prerenal causes, such as dehydration, hypotension, or blood loss, should...
47
Cardiac Catheterization I: Pre-Procedure Overview01:28

Cardiac Catheterization I: Pre-Procedure Overview

Cardiac catheterization is an invasive diagnostic technique used to identify and evaluate structural and functional diseases of the heart and major blood vessels. This technique diagnoses congenital heart disease, coronary artery disease, valvular heart disease, and coronary spasms and assesses ventricular function. It helps guide treatment decisions, including the need for revascularization procedures like percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG) and...
98
Acute Kidney Injury V: Interprofessional Care01:20

Acute Kidney Injury V: Interprofessional Care

Acute Kidney Injury (AKI) requires a collaborative healthcare approach to restore renal function and prevent complications. Essential management strategies involve monitoring fluid and electrolyte balance, adjusting medications, initiating dialysis when necessary, and providing nutritional support.Fluid and Electrolyte ManagementFluid Monitoring: Regularly monitoring body weight, central venous pressure, and urine output helps detect fluid imbalances early. Patient intake and output are...
36
Acute Kidney Injury I: Introduction01:22

Acute Kidney Injury I: Introduction

Introduction:Acute Kidney Injury (AKI) describes a swift decrease in kidney function occurring over hours to days, characterized by the kidneys' failure to remove waste products from the bloodstream. This leads to dangerous complications like metabolic acidosis, fluid overload, and electrolyte imbalances, such as hyperkalemia, which can cause life-threatening arrhythmias. AKI is common in both hospital and outpatient settings, often triggered by dehydration, sepsis, or exposure to nephrotoxic...
48
Acute Kidney Injury III: Clinical Manifestations01:29

Acute Kidney Injury III: Clinical Manifestations

Acute Kidney Injury (AKI) progresses through distinct clinical phases: the oliguric, diuretic, and recovery phases, each marked by unique manifestations and challenges.Oliguric Phase:The oliguric phase is the initial stage of AKI, typically lasting 10 to 14 days. This phase is marked by a significant reduction in urine output, usually less than 400 mL per day, indicating decreased kidney function. Fluid retention is a prominent feature, leading to symptoms such as edema, hypertension, and...
52
Acute Kidney Injury II: Pathophysiology01:29

Acute Kidney Injury II: Pathophysiology

Acute kidney injury (AKI) causes are categorized into three primary categories based on the location of the injury: prerenal, intrarenal (or intrinsic), and postrenal causes. This classification guides clinical management and illustrates how different pathways can impair kidney function.Etiology and Pathophysiology of Acute Kidney Injury1. Prerenal causesEtiology: Prerenal Acute Kidney Injury, the most common type, occurs when reduced blood flow to the kidneys decreases filtration capacity...
40