Abstract
Background and Aims
Contrast-induced nephropathy (CIN) is the main complication of contrast media administration in patients undergoing coronary angiography (CAG). This complication may be accelerated by concurrent renin-angiotensin-aldosterone system (RAAS) blockers . Current literature is inconclusive. We investigated the impact of RAAS blockade on the occurrence of CIN in patients undergoing CAG.
Method
We prospectively enrolled 158 patients who underwent CAG with or without percutaneous coronary intervention from December 2017 to February 2018 at a cardiology department .
CIN was defined as an increase in serum creatinine level >25% or 0.5 mg/dL after 48 hours postcardiac catheterization.
Results
Of 158 patients (females=36.1%, mean age 60.0 ± 11 years) who underwent CAG , 15 (9,5%) developed CIN . Eighty one patients (51,2%) were chronic RAAS blockade users.
There was no significant difference between the two groups, RAAS blockade 'used' versus 'not-used', in the incidence of postprocedural CIN (7,5% vs 11,5%, p=0,38). However , the pre-contrast use of RASS blockers decrease the risk of CIN in patients with chronic renal failure (12,5% vs 66,6% , p=0,042) .
Conclusion
RAAS blockade isn’t associated with a significantly higher incidence of CIN, whereas it has the potential to mitigate the incidence of CIN in patients with chronic renal failure. This low cost intervention could be considered when referring a patient for cardiac catheterization.
Circulating Renin Angiotensin System in Childhood Chronic Renal Failure: Marked Increase of Angiotensin-(1–7) in End-Stage Renal Disease
