Acute renal dysfunction after major arteriography

The incidence of acute renal dysfunction (ARD) after major arteriography was evaluated by assessment of the change in serum creatinine in 364 patients undergoing arteriography. Major arteriography was defined as abdominal aortography, abdominal aortography with lower-extremity runoff, aortic arch studies, or aortic arch plus selective carotid angiography. The influence of the volume of contrast material received, hydration, and associated risk factors was evaluated. In the entire group, the frequency of postarteriographic ARD was 7.1%. Although most patients recovered, 1.4% required renal dialysis. The frequency of renal dysfunction was significantly higher in patients with preexisting renal disease (14.8%), and 3.7% of these patients went on to require dialysis. In the total group and in those with normal renal function prearteriographically, the frequency of ARD was found to be related to the volume of iodinated contrast material received. Hydration before, during, and after angiography did not prevent this complication. Several risk factors, namely preexisting renal disease, advanced age, volume of contrast material used, type of study performed, diabetes mellitus, and coexistent heart disease were found to be associated with a statistically significant increased risk of postangiographic ARD.