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Acute Kidney Injury in Patients Undergoing Both Right and Left Heart Catheterization with Coronary Angiography Vs

Annette Min1, Sumon Roy1, Abhishek Chaturvedi1

  • 1McGuire Veterans Administration Medical Center (VAMC), Richmond, Va; Virginia Commonwealth University, Richmond, Va.

The American Journal of Medicine
|February 2, 2024
PubMed

Insights

Contrast media administration does not significantly increase the risk of acute kidney injury or nephropathy. Renal function changes after procedures are not always caused by contrast agents.

Area of Science:

  • Nephrology
  • Cardiology
  • Radiology

Background:

  • Recent research questions the direct causal link between iodinated contrast media and acute kidney injury.
  • Some acute kidney injury cases may stem from factors independent of contrast administration.

Purpose of the Study:

  • To investigate the association between contrast media administration during cardiac procedures and the incidence of acute kidney injury and nephropathy.
  • To compare renal outcomes in patients undergoing combined right and left heart catheterization with coronary angiography versus right heart catheterization alone.

Main Methods:

  • A retrospective study of 1779 patients undergoing right heart catheterization (RHC) or combined right and left heart catheterization with coronary angiography (R&LHC).
  • Comparison of acute kidney injury incidence at 3 days and nephropathy at 3 months between the two groups.
  • Propensity score-matched analysis was used to adjust for baseline characteristics.

Main Results:

  • The incidence of acute kidney injury at 3 days was similar between the R&LHC group (9.7%) and the RHC group (9.6%) (P = .99).
  • Nephropathy incidence at 3 months was also comparable: 17% in R&LHC versus 19.2% in RHC (P = 0.31).
  • Adjusted analysis showed no significant difference in odds ratios for acute kidney injury (1.25; P = .50) or nephropathy (0.69; P = .08).

Conclusions:

  • The study found no significant difference in acute kidney injury or nephropathy rates between patients undergoing procedures with or without contrast administration.
  • These findings support the hypothesis that contrast media may not be the sole cause of creatinine changes observed post-procedure.
Abstract

Keywords:
Acute kidney injuryContrast mediaCoronary angiographyRight heart catheterization

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