Contrast-induced nephropathy after recanalization chronic coronary occlusion in patients with renal artery stenosis and normal creatinine levels
https://doi.org/10.24884/0042-4625-2023-182-1-65-70
Abstract
Introduction. Contrast-induced nephropathy (CIN) is a complication that occurs after contrast medium (CM) administration. The existing risk scales for possible CIN include chronic kidney disease and do not take into account stenotic changes in the renal artery with normal serum creatinine levels.
The Objective was to study the frequency of CIN in patients with acute and chronic coronary occlusion (CCO) after endovascular recanalization in the presence of hemodynamically significant renal artery damage with initially normal creatinine levels.
Methods and Materials. The study included 38 patients with acute coronary syndrome (control group) and 67 patients with CCO and hemodynamically significant renal artery stenosis (main group). Stenting of one of the renal arteries was performed in 25 patients out of 67 patients before planned coronary revascularization.
Results. The incidences of CIN were significantly higher than the calculated one in patients with CCO and renal artery stenosis. In the group of patients with pre-stenting of the renal arteries, there was a decrease in cases of CIN.
Conclusions. Renal artery stenosis with normal creatinine levels is an additional risk factor for CIN.
About the Authors
N. A. Yaitskiy
Pavlov University
Russian Federation
Russian Federation
Yaitskiy Nikolay A., Dr. of Sci. (Med.), Professor, Academician of the Russian Academy of Sciences, Head of the Department of Hospital Surgery with Clinic,
6-8, L’va Tolstogo str., Saint Petersburg, 197022
O. G. Zverev
Pavlov University;
Saint Petersburg Research Institute of Phthisiopulmonology
Russian Federation
Russian Federation
Zverev Oleg G., Dr. of Sci. (Med.), Professor of the Department of Hospital Surgery with Clinic, 6-8, L’va Tolstogo str., Saint Petersburg, 197022;
Head of the Department of X-ray Surgical Methods of Diagnosis and Treatment, Saint Petersburg
A. V. Voynov
Pavlov University;
Saint Petersburg Research Institute of Phthisiopulmonology
Russian Federation
Russian Federation
Voynov Alexey V., Assistant of the Department of Hospital Surgery with Clinic, 6-8, L’va Tolstogo str., Saint Petersburg, 197022;
Doctor of the Department of X-ray Surgical Methods of Diagnosis and Treatment, Saint Petersburg
S. M. Lazarev
Pavlov University
Russian Federation
Russian Federation
Lazarev Sergey M., Dr. Sci. (Med), Professor, Department of Hospital Surgery with Clinic,
6-8, L’va Tolstogo str., Saint Petersburg, 197022
A. I. Azeyan
Saint Petersburg Research Institute of Phthisiopulmonology
Russian Federation
Russian Federation
Azeyan Alena I., Cardiologist of the Department,
Saint Petersburg
A. F. Bokov
Saint Petersburg Research Institute of Phthisiopulmonology
Russian Federation
Russian Federation
Bokov Alexey F., Research Assistant,
Saint Petersburg
References
1. Choi Y. S., Shim J. K., Kim J. C. et al. Effect of remote ischemic preconditioning on renal dysfunction after complex valvular heart surgery: a randomized controlled trial // J Thorac Cardiovasc Surg. 2011;142(1):148– 54. Doi: 10.1016/j.jtcvs.2010.11.018.
2. Gallagher S. M., Jones D. A., Kapur A. et al. Remote ischemic preconditioning has a neutral effect on the incidence of kidney injury after coronary artery bypass graft surgery // Kidney Int. 2015;87(2):473–81. Doi: 10.1038/ki.2014.259.
3. Sun Q., Shen Z. Y., Duan W. N., Meng Q. T., Xia Z. Y. Mechanism of myocardial ischemia/reperfusion-induced acute kidney injury through DJ-1/ Nrf2 pathway in diabetic rats // Exp. Ther. Med. 2017;14(5):4201–4207. Doi: 10.3892/etm.2017.5095.
4. Yang Y., George K. C., Luo R. et al. Contrast-induced acute kidney injury and adverse clinical outcomes risk in acute coronary syndrome patients undergoing percutaneous coronary intervention: a meta-analysis // BMC Nephrol. 2018;19(1):374. Doi:10.1186/s12882-018-1161-5.
5. Demchuk O. V., Sukmanova I. A., Ponomarenko I. V., Elykomov V. A. Contrast-induced nephropathy in patients with acute coronary syndrome: clinical significance, diagnosis, prophylaxis // Cardiovascular Therapy and Prevention. 2020;19(2):2255. (In Russ.).
6. Hong W. Y., Kabach M., Feldman G. et al. Intravenous fluids for the prevention of contrast-induced nephropathy in patients undergoing coronary angiography and cardiac catheterization // Expert Rev. Cardiovasc. Ther. 2020;18:33–39.
7. Rudnick M. R., Leonberg-Yoo A. K., Litt H. I. et al. The controversy of contrast-induced nephropathy with intravenous contrast: what is the risk? // Am. J. Kidney Dis. 2020;75(1):105–113. Doi: 10.1053/j.ajkd.2019.05.022.
8. Zhang J. Y., Wang Q., Wang R. T. et al. Increased urinary adiponectin level is associated with contrast-induced nephropathy in patients undergoing elective percutaneous coronary intervention // BMC Cardiovasc Disord. 2019;19(1):160. Doi: 10.1186/s12872-019-1143-y. PMID: 31269899; PMCID: PMC6610850.
9. Gruberg L., Mintz G. S., Mehran R. et al. The prognostic implications of further renal function deterioration within 48 h of interventional coronary procedures in patients with pre-existent chronic renal insufficiency // J. Am. Coll. Cardiol. 2000;36(5):1542–8.
10. Rihal C. S., Textor S. C., Grill D. E. et al. Incidence and prognostic importance of acute renal failure after percutaneous coronary intervention // Circulation. 2002;105(19):2259–64. Doi: 10.1161/01.cir.0000016043.87291.33. PMID: 12010907.
11. Viscoli C. M., Horwitz R. I. The effect of acute renal failure on mortality. A cohort analysis // JAMA. 1996;275(19):1489–94.
12. Mueller C., Buerkle G., Buettner H. J. et al. Prevention of contrast mediaassociated nephropathy: randomized comparison of 2 hydration regimens in 1620 patients undergoing coronary angioplasty // Arch. Intern. Med. 2002;162(3):329–36.
13. Trivedi H. S., Moore H., Nasr S. et al. A randomized prospective trial to assess the role of saline hydration on the development of contrast nephrotoxicity // Nephron. Clin. Pract. 2003;93(1):C29–34.
14. Mehran R., Aymong E. D., Nikolsky E. et al. A simple risk score for prediction of contrast-induced nephropathy after percutaneous coronary intervention: development and initial validation // J. Am. Coll. Cardiol. 2004;44:1393–1399.
15. Zanoli L., Rastelli S., Marcantoni C. et al. Reference renal artery diameter is a stronger predictor of contrast-induced nephropathy than chronic kidney disease in patients with high cardiovascular risk // Nephron Extra. 2011;1(1):38–44. Doi: 10.1159/000329895. PMID: 22470377; PMCID: PMC3290859
16. Grum H. S., Dixon S. R., Smith D. E. et al. BMC2 (Blue Cross Blue Shield of Michigan Cardiovascular Consortium) Registry. Renal functionbased contrast dosing to define safe limits of radiographic contrast media in patients undergoing percutaneous coronary interventions // J. Am. Coll. Cardiol. 2011;58:907–14.
17. Nyman U., Björk J., Aspelin P., Marenzi G. Contrast medium dosetoGFR ratio: a measure of systemic exposure to predict contrastinduced nephropathy after percutaneous coronary intervention // Acta Radiol. 2008;49:658–67.
18. Koide M., Kato M., Usui K. et al. Successful complete revascularization with PCI using super-low volume of contrast medium in a patient with three-vessel disease including 2 chronic total occlusions with severe renal dysfunction // Int. Heart J. 2017;58(4):624–628. Doi: 10.1536/ihj.16-442.
19. Manske C. L., Sprafka J. M., Strony J. T., Wang Y. Contrast nephropathy in azotemic diabetic patients undergoing coronary angiography // Am J Med. 1990;89(5):615–20. Doi: 10.1016/0002-9343(90)90180-l. PMID: 2239981.
20. Yaitsky N. A., Zverev O. G., Volkov A. B., Riabikov M. A., Bedrov A. Ia., Voĭnov A. V. Restoration of renal blood flow and excretory function after successful revascularization in chronic renal artery occlusion // Grekov’s Bulletin of Surgery. 2015;174(2):101–2. (In Russ.).
21. Rihal C. S., Textor S. C., Grill D. E. et al. Incidence and prognostic importance of acute renal failure after percutaneous coronary intervention // Circulation. 2002;105(19):2259–64. Doi: 10.1161/01.cir.0000016043.87291.33. PMID: 12010907.
22. Valappil S. P., Kunjukrishnapillai S., Iype M. et al. Predictors of contrast induced nephropathy and the applicability of the Mehran risk score in high risk patients undergoing coronary angioplasty-A study from a tertiary care center in South India // Indian Heart J. 2018;70(3):399–404. Doi: 10.1016/j.ihj.2017.08.018.
23. Cigarroa R. G., Lange R. A., Williams R. H. Dosing of contrast material to prevent contrast nephropathy in patients with renal disease // Am J Med. 1989;86:649–652.
24. Gruberg L., Mintz G. S., Mehran R. et al. The prognostic implications of further renal function deterioration within 48 h of interventional coronary procedures in patients with pre-existent chronic renal insufficiency // J. Am. Coll. Cardiol. 2000;36(5):1542–8.
25. He H., Chen X. R., Chen Y. Q. et al. Prevalence and predictors of Contrast-Induced Nephropathy (CIN) in patients with STSegment Elevation Myocardial Infarction (STEMI) undergoing Percutaneous Coronary Intervention (PCI): a metaanalysis // J. Interv. Cardiol. 2019; 2019:2750173.
Review
For citations:
Yaitskiy N.A., Zverev O.G., Voynov A.V., Lazarev S.M., Azeyan A.I., Bokov A.F. Contrast-induced nephropathy after recanalization chronic coronary occlusion in patients with renal artery stenosis and normal creatinine levels. Grekov's Bulletin of Surgery. 2023;182(1):65-70. (In Russ.) https://doi.org/10.24884/0042-4625-2023-182-1-65-70
Views:
268
Email this article 