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Acute renal dysfunction after major arteriography.

A S Gomes, J D Baker, V Martin-Paredero

    AJR. American Journal of Roentgenology
    |December 1, 1985
    PubMed
    Summary
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    Major arteriography can cause acute renal dysfunction (ARD), affecting 7.1% of patients. Preexisting kidney disease and contrast volume significantly increase ARD risk, with some cases requiring dialysis.

    Area of Science:

    • Nephrology
    • Radiology
    • Cardiovascular Medicine

    Background:

    • Major arteriography procedures carry a risk of acute renal dysfunction (ARD).
    • Understanding risk factors for post-arteriography ARD is crucial for patient management.

    Purpose of the Study:

    • To evaluate the incidence of ARD after major arteriography.
    • To identify factors influencing ARD development, including contrast volume, hydration, and patient comorbidities.

    Main Methods:

    • Serum creatinine changes were assessed in 364 patients undergoing major arteriography.
    • Major arteriography included abdominal aortography, lower-extremity runoff, aortic arch, and selective carotid angiography.
    • Analysis included contrast volume, hydration status, and pre-existing risk factors.

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    Main Results:

    • The overall incidence of post-arteriographic ARD was 7.1%, with 1.4% requiring renal dialysis.
    • Patients with pre-existing renal disease had a significantly higher ARD rate (14.8%), with 3.7% needing dialysis.
    • ARD incidence correlated with iodinated contrast volume in the total group and those with normal pre-arteriography renal function.
    • Hydration did not prevent ARD. Risk factors included pre-existing renal disease, advanced age, contrast volume, study type, diabetes, and heart disease.

    Conclusions:

    • Major arteriography is associated with a notable risk of ARD.
    • Pre-existing renal disease, contrast volume, and other comorbidities significantly elevate the risk of ARD.
    • Proactive risk assessment and management are essential for patients undergoing major arteriography.