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Risks for renal dysfunction with cardiac angiography.

C P Taliercio, R E Vlietstra, L D Fisher

    Annals of Internal Medicine
    |April 1, 1986
    PubMed
    Summary
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    Contrast nephropathy, kidney damage from contrast dye, affects 23% of patients with pre-existing kidney issues undergoing cardiac angiography. Risk factors include heart failure, multiple contrast studies, and diabetes.

    Area of Science:

    • Nephrology
    • Cardiology
    • Radiology

    Background:

    • Patients with abnormal renal function undergoing cardiac angiography are at risk for contrast nephropathy.
    • Contrast nephropathy is defined as a significant rise in serum creatinine post-procedure.

    Purpose of the Study:

    • To determine the incidence of contrast nephropathy in patients with pre-existing renal dysfunction undergoing cardiac angiography.
    • To identify independent risk factors associated with contrast nephropathy in this patient population.

    Main Methods:

    • Retrospective analysis of 139 patients with serum creatinine ≥ 2.0 mg/dL undergoing 141 cardiac angiographies.
    • Stepwise logistic regression was used to identify independent predictors of contrast nephropathy.

    Main Results:

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    • The overall incidence of contrast nephropathy was 23%.
    • Independent risk factors identified were: class IV heart failure with low cardiac output (71% incidence), multiple radiocontrast studies within 72 hours (50%), dose of radiocontrast, and insulin-dependent diabetes mellitus (44%).
    • Patients without these risk factors had a lower incidence (2% with <125 mL contrast vs. 19% with ≥125 mL contrast).

    Conclusions:

    • Contrast nephropathy is a significant complication in patients with pre-existing renal dysfunction undergoing cardiac procedures.
    • Identifying and mitigating risk factors such as heart failure, multiple contrast exposures, and diabetes is crucial for prevention.