scholarly journals Contrast-induced nephropathy in patients with chronic kidney disease and peripheral arterial disease

2015 ◽  
Vol 4 (6) ◽  
pp. 205846011558303 ◽  
Author(s):  
Christian Kroneberger ◽  
Christian N Enzweiler ◽  
Andre Schmidt-Lucke ◽  
Ralph-Ingo Rückert ◽  
Ulf Teichgräber ◽  
...  
Keyword(s):  
Risk Factors ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Peripheral Arterial Disease ◽  
Serum Creatinine ◽  
Contrast Material ◽  
Arterial Disease ◽  
Contrast Induced Nephropathy ◽  
Related Risk ◽  
Peripheral Arterial

Background The risk for contrast-induced nephropathy (CIN) after intra-arterial application of an iodine-based contrast material is unknown for patients with chronic kidney disease (CKD) and peripheral arterial disease (PAD). Purpose To investigate the incidence of CIN in patients with CKD and PAD. Material and Methods This retrospective study was approved by the local ethics committee. One hundred and twenty patients with 128 procedures (73 with baseline eGFR in the range of 45–60 mL/min/1.73m2, 55 with eGFR < 45 mL/min/1.73m2) were evaluated. All patients received intra-arterially an iodine-based low-osmolar contrast material (CM) after adequate intravenous hydration with isotonic NaCl 0.9% solution. CIN was defined as an increase in serum creatinine of more than 44 μmol/L within 4 days. The influence of patient-related risk factors (age, weight, body mass index, eGFR, serum creatinine, hypertension, diabetes mellitus, coronary heart disease, heart failure) and therapy-related risk factors (amount of CM, nephrotoxic drugs, number of CM applications) on CIN were examined. Results CIN developed in 0% (0/73) of procedures in patients with PAD and an eGFR in the range of 45–60 mL/min/1.73m2 and in 10.9% (6/55) of procedures in patients with an eGFR <45 mL/min/1.73m2. No risk factor significantly influenced the development of CIN, although baseline serum creatinine ( P = 0.06) and baseline eGFR ( P = 0.10) showed a considerable dependency. Conclusion Patients with an eGFR in the range of 45–60 mL/min/1.73m2 and PAD seem not at risk for CIN after intra-arterial CM application and adequate hydration. Whereas, an eGFR < 45 mL/min/1.73m2 correlated with a risk of 10.9% for a CIN.

scholarly journals Subclinical peripheral arterial disease in patients with chronic kidney disease: Prevalence and related risk factors

2005 ◽  
Vol 67 ◽  
pp. S44-S47 ◽  
Author(s):  
Soledad Garcia de Vinuesa ◽  
Mayra Ortega ◽  
Patricia Martinez ◽  
Marian Goicoechea ◽  
Francisco Gomez Campdera ◽  
...  
Keyword(s):  
Risk Factors ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Peripheral Arterial Disease ◽  
Arterial Disease ◽  
Disease Prevalence ◽  
Chronic Kidney Disease Prevalence ◽  
Related Risk ◽  
Peripheral Arterial

scholarly journals Risk Factors for Peripheral Arterial Disease Among Patients With Chronic Kidney Disease

2012 ◽  
Vol 110 (1) ◽  
pp. 136-141 ◽  
Author(s):  
Jing Chen ◽  
Emile R. Mohler ◽  
Dawei Xie ◽  
Michael G. Shlipak ◽  
Raymond R. Townsend ◽  
...  
Keyword(s):  
Risk Factors ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Peripheral Arterial Disease ◽  
Arterial Disease ◽  
Peripheral Arterial

Assessment of Renal Function and Risk Factors for Chronic Kidney Disease in Patients With Peripheral Arterial Disease

Angiology ◽  
2017 ◽  
Vol 68 (9) ◽  
pp. 776-781 ◽  
Author(s):  
Xi-Bei Jia ◽  
Xi-Hua Hou ◽  
Qiu-Bo Ma ◽  
Xiao-Wen Cai ◽  
Yi-Ran Li ◽  
...  
Keyword(s):  
Risk Factors ◽  
Chronic Kidney Disease ◽  
Renal Function ◽  
Kidney Disease ◽  
Peripheral Arterial Disease ◽  
Arterial Disease ◽  
High Risk Population ◽  
High Prevalence ◽  
Independent Risk Factors ◽  
Peripheral Arterial

Chronic kidney disease (CKD) and peripheral arterial disease (PAD) share common risk factors. We assessed renal function and the prevalence of CKD in patients with PAD and investigated the characteristics of the risk factors for CKD in this population. Renal function of 421 patients with PAD was evaluated. Among the participants, 194 (46.1%) patients had decreased estimated glomerular filtration rate (eGFR). The prevalence of CKD was much higher among patients with PAD. Hypertension (odds ratios [ORs] 2.156, 95% confidence interval [CI] 1.413-3.289, P < .001), serum uric acid (OR 3.794, 95% CI 2.220-6.450, P < .001), and dyslipidemia (OR 1.755, 95% CI 1.123-2.745, P = .014) were significantly associated with CKD and the independent risk factors for CKD in patients with PAD. CKD is common and has a high prevalence in a population with PAD. Patients with PAD may be considered as a high-risk population for CKD. Recognition and modification of risk factors for CKD might beneficially decrease CKD incidence and improve prognosis in patients with PAD.

Abstract 20579: Chronic Kidney Disease is Associated With Increased Mortality and Major Adverse Cardiovascular Events in Patients With Peripheral Arterial Disease

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Gregory G Westin ◽  
Ehrin J Armstrong ◽  
Debbie C Chen ◽  
John R Laird
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Peripheral Arterial Disease ◽  
Cardiovascular Events ◽  
Cox Model ◽  
Univariate Analysis ◽  
Arterial Disease ◽  
Major Adverse Cardiovascular Events ◽  
Ckd Stage ◽  
Peripheral Arterial

Introduction: Chronic kidney disease (CKD) is common in patients with peripheral arterial disease (PAD), but patients with severe CKD have been excluded from many trials and no objective performance goals exist for patients with PAD and CKD. We sought to analyze the association between severity of CKD and cardiovascular and limb-related outcomes among patients with PAD. Methods: We reviewed records of all patients at our institution who underwent lower extremity angiography between 2006 and 2013. We analyzed outcomes including mortality, major adverse cardiovascular event (MACE) rate, and major adverse limb event (MALE) rate according to clinical stage of CKD, determined by calculating each patient’s glomerular filtration rate using the Cockcroft-Gault equation. We used Cox proportional hazard modeling to account for covariates, along with Bonferroni correction for multiple comparisons. Results: Of 773 patients, 45% had CKD stage 3-5. The patients had a median age of 67, were 58% male, 51% diabetic, and 57% presented with critical limb ischemia (CLI). During a median follow-up time of 3.2 years, patients with higher stages of CKD had an increased rate of death (Figure 1, p<0.001). CKD stages 4 and 5 were significant predictors of mortality in a multivariate model (HR 3.2 and 2.4 vs. CKD 1, P<0.001 and P<0.01, respectively). An analysis of MACE by CKD stage demonstrated similar results (CKD 4 HR 2.2, p<0.01; CKD 5 HR 2.0, p<0.01). CKD stage also predicted MALE in a univariate analysis (p<0.01), driven by increased limb events among patients with CKD stage 5 (p<0.01). However, CKD stage did not demonstrate a significantly increased hazard of MALE in a multivariate Cox model. Conclusions: Patients with PAD who also have CKD have increased rates of adverse outcomes. This relationship seems to be more robust for major cardiovascular events and overall mortality than for major limb events. Future studies should investigate how management of PAD should differ for patients with CKD.

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