Controversies in cardio-nephrology: contrast nephropathy

Coronary intervention is associated with the appearance of contrast-induced nephropathy. The purpose of the study was to assess the risk of developing contrast-induced nephropathy in patients with significant coronary obstruction and its relationship with known risk factors for this nephropathy. A prospective cohort study was designed with 160 patients treated at the cardiocenter of the “Hermanos Ameijeiras” hospital, Cuba, who underwent invasive coronary angiography, between January 2016 and July 2017. The average age was 61.6 ± 9 ,2 years; 70.6% were men. The personal pathological history of ischemic heart disease (85.6%) and arterial hypertension (75.6%) predominated. 75% of the cases presented a significant coronary occlusion. The frequency of contrast nephropathy was 42.5%. The factors that had an important statistical relationship with the presence of significant arterial occlusion were known ischemic heart disease (p <0.001), previous percutaneous coronary intervention (p = 0.007), creatinine after the procedure (p = 0.043) and CIN (p = 0.016) as well as the volume of contrast administered (p = 0.006). In the subgroup of patients with significant occlusion, low hematocrit (p = 0.025) and emergency percutaneous coronary intervention (p = 0.007) were the most influential factors. It is concluded that patients with significant coronary occlusion have an increased risk for the development of contrast nephropathy. The correction of those risk factors that are modifiable (such as low hematocrit) and the correct application of the hydration protocol are essential to prevent this complication.

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Complications

Cardiac Catheterization and Coronary Intervention ◽

10.1093/med/9780198705642.003.0010 ◽

2020 ◽

pp. 277-314

Author(s):

Andrew Mitchell ◽

Giovanni Luigi De Maria ◽

Adrian Banning

Keyword(s):

Cardiac Catheterization ◽

Vascular Complications ◽

Air Embolism ◽

Limb Ischaemia ◽

Contrast Nephropathy ◽

Diagnostic Cardiac Catheterization ◽

Vasovagal Reactions ◽

Co Morbidity ◽

Coronary Perforation ◽

Haematoma Formation

Cardiac catheterization is an invasive study that involves real risks to the patient. The risks increase with patient age and co-morbidity. Though vascular complications (particularly haematoma formation) and vasovagal reactions are more common, the risk of serious complications from diagnostic cardiac catheterization and coronary angiography remains low. This chapter covers complications that may arise, including death, myocardial infarction, pulmonary oedema, stroke, hypotension, cardiac tamponade, contrast reactions, vasovagal reactions, arrhythmias, vascular complications, limb ischaemia, coronary dissection (including left main stem dissection and iatrogenic type A aortic dissection), air embolism, coronary perforation, renal failure, contrast nephropathy, and cholesterol embolization.

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Contrast Nephropathy and Kidney Injury

Textbook of Cardiovascular Intervention ◽

10.1007/978-1-4471-4528-8_5 ◽

2013 ◽

pp. 53-63 ◽

Cited By ~ 2

Author(s):

Jeremiah R. Brown ◽

Peter A. McCullough

Keyword(s):

Kidney Injury ◽

Contrast Nephropathy

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