Predictors and Outcomes of Postcontrast Acute Kidney Injury after Endovascular Renal Artery Intervention

Abstract

Purpose To determine the incidence, predictors and clinical outcomes of post-contrast acute kidney injury (PC-AKI) following renal artery stent placement for atherosclerotic renal artery stenosis. Materials and Methods This retrospective study reviewed 1,052 patients who underwent renal artery stent placement for atherosclerotic renal artery stenosis. In total, 437 patients with follow-up were included in this study. Mean age was 73.6 ± 8.3 years. Post-contrast acute kidney injury was defined as an absolute serum creatinine increase ≥0.3 mg/dL or percentage increase in serum creatinine ≥50% within 48 hours of intervention. Logistic regression analysis was performed to identify risk factors for PC-AKI. The cumulative proportion of patients who died or went on to hemodialysis was determined using Kaplan-Meier survival analysis. Results Mean follow-up was 71.1±68.4 months. Twenty-six patients (5.9%) developed PC-AKI. Patients who developed PC-AKI had significantly higher levels of baseline proteinuria compared to those who did not (Odds ratio 1.38; 95% CI 1.11–1.72; P=0.004). Prehydration, chronic kidney disease stage, baseline GFR, statin medications, contrast volume and iodine load were not associated with higher rates of PC-AKI. Dialysis-free survival and mortality rates were not significantly different between patients with and without PC-AKI (P=0.50 and P=0.17, respectively). Conclusion Elevated baseline proteinuria was the only predictor for PC-AKI in patients undergoing renal artery stent placement. Patients who developed PC-AKI were not at greater risk for hemodialysis or death.

A Novel Antioxidant Protects Against Contrast Medium-Induced Acute Kidney Injury in Rats

“…CI-AKI is one of the main causes of hospital-acquired AKI (Takahashi et al, 2017), and it is generally acknowledged as animal model to explore the efficiency of protective agents. Iohexol is our choice of a radiocontrast agent, a low-osmolar nonionic dimeric iodinated contrast medium, also reflects common clinical practice.…”

The Ratio of Fibrinogen to Albumin as a Predictor of Contrast-Induced Nephropathy After Carotid Angiography

“…32 A relationship has also been established between increased baseline proteinuria and CIN in patients undergoing renal artery stent placement. 33 C-reactive protein was found to be an independent predictor of CIN after coronary angiography. 34 In recent studies, PLR and NLR emerged as independent predictors of CIN in patients with STEMI after primary PCI.…”

Resveratrol Protects Against Post-Contrast Acute Kidney Injury in Rabbits With Diabetic Nephropathy

“…Post-contrast acute kidney injury is one of the leading causes of hospital-acquired acute kidney injury (Takahashi et al, 2017; Van Der Molen et al, 2018). Epidemiological and clinical evidence suggests that diabetes mellitus plays a part in the development of PC–AKI after the use of contrast medium (Tziakas et al, 2014; Chalikias et al, 2016).…”

“…Post-contrast acute kidney injury (PC–AKI), described as a decrease in renal function that follows the intravascular administration of contrast medium, is one of the leading causes of hospital-acquired acute kidney injury (Takahashi et al, 2017; Van Der Molen et al, 2018). This type of injury is associated with adverse short- and long-term outcomes (Maioli et al, 2012; Chalikias et al, 2016).…”