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Updated: Aug 1, 2025
Assessment of Vascular Function in Patients With Chronic Kidney Disease
Published on: June 16, 2014
Contrast-Induced Acute Kidney Injury and Endothelial Dysfunction: The Role of Vascular and Biochemical Parameters
Adolfo Marco Perrotta1, Antonietta Gigante2, Silverio Rotondi1
1Nephrology Unit, Department of Translational and Precision Medicine, Sapienza University of Rome, 00185 Rome, Italy.
Insights
The renal resistive index (RRI) and intima-media thickness (IMT) may help predict contrast-induced acute kidney injury (CIAKI) after coronary angiography. Higher RRI and IMT were associated with CIAKI development, indicating potential for early detection.
Area of Science:
- Nephrology
- Cardiology
- Radiology
Background:
- Contrast-induced acute kidney injury (CIAKI) is a significant complication of iodinated contrast media, leading to acute renal failure and increased cardiovascular risk.
- CIAKI is a feared complication of coronary angiography, associated with poor prognosis, high morbidity, and mortality.
Purpose of the Study:
- To investigate the association between renal resistive index (RRI) and CIAKI development.
- To explore the relationship between RRI, subclinical atherosclerosis markers, and cardiovascular risk factors.
Main Methods:
- 101 patients undergoing coronary angiography were assessed for renal function, inflammation markers (CRP, SUA), and atherosclerosis indicators (RRI, IMT, ABI).
- Renal function and inflammatory markers were measured at baseline and 48-72 hours post-contrast administration.
- RRI, intima-media thickness (IMT), interventricular septum (IVS), and ankle-brachial index (ABI) were evaluated.
Main Results:
- 19% of patients developed CIAKI, with a higher incidence (23%) in diabetic patients.
- Patients with CIAKI exhibited significantly higher RRI (p < 0.001) and IMT (p < 0.001) compared to those without CIAKI.
- Elevated C-reactive protein (CRP) and serum uric acid (SUA) were also significantly associated with CIAKI development.
Conclusions:
- Significant differences in RRI, IMT, SUA, and CRP were observed between patients who developed CIAKI and those who did not.
- RRI and IMT are identified as cost-effective, non-invasive markers for endothelial dysfunction and atherosclerosis.
- These findings suggest RRI and IMT could be valuable in predicting CIAKI risk.
Introduction:
Contrast-induced acute kidney injury (CIAKI) is one of the main causes of acute renal failure in hospitalized patients, following the administration of iodinated contrast medium used for CT scans and angiographic procedures. CIAKI determines a high cardiovascular risk and appears to be one of the most feared complications of coronary angiography, causing a notable worsening of the prognosis with high morbidity and mortality.
Aim:
To evaluate a possible association between the renal resistive index (RRI) and the development of CIAKI, as well as an association with the main subclinical markers of atherosclerosis and the main cardiovascular risk factors.
Materials And Methods:
We enrolled 101 patients with an indication for coronary angiography. Patients underwent an assessment of renal function (serum nitrogen and basal creatinine, 48 and 72 h after administration of contrast medium), inflammation (C reactive protein (CRP), serum calcium and phosphorus, intact parathormone (iPTH), 25-hydroxyvitaminD (25-OH-VitD), serum uric acid (SUA), total cholesterol, serum triglycerides, serum glucose and insulin). All patients also carried out an evaluation of RRI, intima-media thickness (IMT), interventricular septum (IVS) and the ankle-brachial index (ABI).
Results:
101 patients (68 male), with a mean age of 73.0 ± 15.0 years, were enrolled for the study; 35 are affected by type 2 diabetes mellitus. A total of 19 cases of CIAKI were reported (19%), while among diabetic patients we reported an incidence of 23% (8 patients). In our study, patients with CIAKI had significantly higher RRI (p < 0.001) and IMT (p < 0.001) with respect to the patients who did not develop CIAKI. Furthermore, patients with CIAKI had significantly higher CRP (p < 0.001) and SUA (p < 0.006).
Conclusions:
We showed a significant difference in RRI, IMT, SUA and CRP values between the population developing CIAKI and patients without CIAKI. This data appears relevant considering that RRI and IMT are low-cost, non-invasive and easily reproducible markers of endothelial dysfunction and atherosclerosis.
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