Transient and persistent renal dysfunction are predictors of survival after percutaneous coronary intervention: Insights from the Dartmouth Dynamic Registry

Brown, Jeremiah R.; Malenka, David J.; DeVries, James T.; Robb, John F.; Jayne, John E.; Friedman, Bruce J.; Hettleman, Bruce; Niles, Nathaniel W.; Kaplan, Aaron V.; Schoolwerth, Anton C.; Thompson, Craig A.

doi:10.1002/ccd.21619

Cited by 111 publications

(76 citation statements)

References 40 publications

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“…4 In the present study, consecutive patients undergoing PCI were prospectively enrolled in the Dartmouth Dynamic Registry from 2000 to 2008 (nϭ10 065). Patients with preexisting dialysis-dependent renal failure were excluded (nϭ155).…”

Section: Methodsmentioning

confidence: 99%

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Does Safe Dosing of Iodinated Contrast Prevent Contrast-Induced Acute Kidney Injury?

Brown

Robb

Block

et al. 2010

Circ: Cardiovascular Interventions

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Background-Previous work on contrast-induced acute kidney injury (CI-AKI) has identified contrast volume as a risk factor and suggested that there is a maximum allowable contrast dose (MACD) above which the risk of CI-AKI is markedly increased. We hypothesized that there is a relationship between contrast volume and CI-AKI and that there might be reason to track incremental contrast volumes above and below the MACD limit. Methods and Results-Consecutive patients undergoing percutaneous coronary intervention (PCI) were prospectively enrolled from 2000 to 2008 (nϭ10 065). Patients on dialysis before PCI were excluded (nϭ155). MACD was defined as (5 mLϫbody weight [kg])/baseline serum creatinine [mg/dL]) and divided into categories in which 1.0 reflects the MACD limit: ՅMACD ratios (Ͻ0.5, 0.5 to 0.75, and 0.75 to 1.0) and ϾMACD (1.0 to 1.5, 1.5 to 2.0, and Ͼ2.0). CI-AKI was defined as a Ն0.3 (mg/dL) or Ն50% increase in serum creatinine from baseline or new dialysis. Multivariable regression was conducted to evaluate the effect of exceeding the MACD on CI-AKI.

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Section: Methodsmentioning

confidence: 99%

“…CI-AKI results from acute tubular necrosis from nephrotoxic iodinated contrast dye administered intraarterially during the procedure and from other homeostatic factors 2,3 and is a serious complication resulting in increased short-and long-term mortality and morbidity. 4 …”

mentioning

confidence: 99%

Does Safe Dosing of Iodinated Contrast Prevent Contrast-Induced Acute Kidney Injury?

Brown

Robb

Block

et al. 2010

Circ: Cardiovascular Interventions

Self Cite

146

125

View full text Add to dashboard Cite

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“…12 It has been assumed by many that CI-AKI identifies patients with a greater burden of comorbidity and that the long-term adverse outcomes in patients who develop CI-AKI reflect that burden. This is analogous to the development of bleeding complications after coronary intervention.…”

Section: Impact/outcomementioning

confidence: 99%

Contrast-Induced Acute Kidney Injury

2010

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“…The most common definition of CI-AKI is a rise in serum creatinine levels by ≥0.3 mg/dl within 48 h of contrast administration. CI-AKI has been associated with progression to advanced stages of chronic kidney disease (CKD) and with increased risk for major adverse cardiac events (MACE) [3,4].CI-AKI is the third most common cause of hospital-acquired renal failure and is associated with increased morbidity, prolonged hospitalization and higher rates of in-hospital and long-term mortality [5,6]. The incidence of CI-AKI varies from 2% in the general population to over 50% in high-risk groups [7].…”

mentioning

confidence: 99%

“…CI-AKI is the third most common cause of hospital-acquired renal failure and is associated with increased morbidity, prolonged hospitalization and higher rates of in-hospital and long-term mortality [5,6]. The incidence of CI-AKI varies from 2% in the general population to over 50% in high-risk groups [7].…”

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confidence: 99%

Iso-osmolar contrast media and adverse renal and cardiac events after percutaneous cardiovascular intervention

et al. 2018

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Aim: To assess the relationship between type of contrast media (CM), iso-osmolar contrast media (IOCM) or low-osmolar contrast media (LOCM), and major adverse renal and cardiovascular events (MARCE). Materials & methods: Coronary or peripheral angioplasty visits were stratified into CM cohorts: IOCM or LOCM. Multivariable regression analysis used hospital fixed effects to assess the relationship between MARCE events and type of CM. Results: Among 333,533 visits (357 hospitals), the incidence of MARCE was 7.41%. After controlling for observable and unobservable time invariant within-hospital characteristics, administration of IOCM versus LOCM was associated with a 0.69% absolute and 9.32% relative risk reduction in MARCE rate. Conclusion: Our study indicates that as compared with LOCM, IOCM may be associated with reduction of MARCE events in coronary or peripheral angioplasty patients. Arterial angiography and percutaneous intervention require administration of iodinated contrast media (CM) to render the blood vessels radiographically opaque. Contrast-induced acute kidney injury (CI-AKI) is one of the major adverse events associated with administration of iodinated CM [1,2]. The most common definition of CI-AKI is a rise in serum creatinine levels by ≥0.3 mg/dl within 48 h of contrast administration. CI-AKI has been associated with progression to advanced stages of chronic kidney disease (CKD) and with increased risk for major adverse cardiac events (MACE) [3,4].CI-AKI is the third most common cause of hospital-acquired renal failure and is associated with increased morbidity, prolonged hospitalization and higher rates of in-hospital and long-term mortality [5,6]. The incidence of CI-AKI varies from 2% in the general population to over 50% in high-risk groups [7]. In studies of the impact of the osmolality of iodinated CM, the use of low-osmolar contrast media (LOCM) has been shown to substantially reduce the risk of nephropathy when compared with high-osmolar CM [8][9][10][11].In several studies, iodixanol, iso-osmolar contrast media (IOCM) have been associated with lower risk for CI-AKI when compared with LOCM [12][13][14][15][16]. In a meta-analysis of 16 randomized controlled trials, McCullough et al. found that CI-AKI occurred less frequently for all patients in the iodixanol group when compared with the LOCM group [15]. Similar findings were reported for the subgroup of patients with CKD and for patients with CKD and diabetes mellitus. More recent meta-analysis concluded that iodixanol use was associated with less nephrotoxicity compared with LOCM and that use of iodixanol was associated with significantly fewer contrast-induced nephropathy events compared with LOCM [12]. Both meta-analyses concluded that intra-arterial

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Transient and persistent renal dysfunction are predictors of survival after percutaneous coronary intervention: Insights from the Dartmouth Dynamic Registry

Abstract: Both transient and persistent postprocedural renal dysfunction are prognostically significant for mortality during extended follow-up. Renal dysfunction should be closely monitored before and after PCI.

Cited by 111 publications

References 40 publications

Does Safe Dosing of Iodinated Contrast Prevent Contrast-Induced Acute Kidney Injury?

Does Safe Dosing of Iodinated Contrast Prevent Contrast-Induced Acute Kidney Injury?

Contrast-Induced Acute Kidney Injury

Iso-osmolar contrast media and adverse renal and cardiac events after percutaneous cardiovascular intervention

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