Risk of Worsening Renal Function Following Repeated Exposures to Contrast Media During Percutaneous Coronary Interventions

Background Multiple contrast media exposures are common, but their cumulative effect on renal function is unknown. We aimed to investigate the renal consequences of repeated exposures to contrast media with coronary interventions. Methods and Results We studied 2942 patients who underwent between 1...

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Autores principales:	Doron Sudarsky, Robert Naami, Faheem Shehadeh, Adi Elias, Arthur Kerner, Doron Aronson
Formato:	article
Lenguaje:	EN
Publicado:	Wiley 2021
Materias:	acute kidney injury contrast media contrast‐induced nephropathy Diseases of the circulatory (Cardiovascular) system RC666-701
Acceso en línea:	https://doaj.org/article/81edfdb1a4f7472f8e868eff00a49ef6
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spelling	oai:doaj.org-article:81edfdb1a4f7472f8e868eff00a49ef62021-11-23T11:36:34ZRisk of Worsening Renal Function Following Repeated Exposures to Contrast Media During Percutaneous Coronary Interventions10.1161/JAHA.121.0214732047-9980https://doaj.org/article/81edfdb1a4f7472f8e868eff00a49ef62021-09-01T00:00:00Zhttps://www.ahajournals.org/doi/10.1161/JAHA.121.021473https://doaj.org/toc/2047-9980Background Multiple contrast media exposures are common, but their cumulative effect on renal function is unknown. We aimed to investigate the renal consequences of repeated exposures to contrast media with coronary interventions. Methods and Results We studied 2942 patients who underwent between 1 and 9 procedures. The primary end point was a persistent creatinine increase of ≥50% above baseline at ≥90 days after the last procedure. The effect of cumulative contrast media dose was assessed using Cox models, with cumulative exposure as a time‐dependent variable, and propensity score matching. The primary end point occurred in 190 patients (6.5%), with 6.1%, 6.8%, and 6.2% of patients with 1, 2 or 3, and ≥4 procedures, respectively (P=0.75). In the multivariable Cox model, baseline renal function, diabetes, anemia, acute coronary syndrome, and heart failure were independent predictors of the primary end point (all P≤0.01), whereas cumulative contrast dose was not (hazard ratio [HR], 1.29 [95% CI, 0.89–1.88] for the fourth contrast quartile [>509 mL] versus first contrast quartile [<233 mL]). Propensity score matching yielded 384 patient pairs with similar characteristics and either 1 or 2 to 9 contrast exposures (median cumulative dose, 160 and 480 mL, respectively). Despite large differences in the cumulative contrast exposure, there were similar rates of the primary end points (7.3% versus 6.3%, respectively; HR, 0.76 [95% CI, 0.44–1.32]). Conclusions In patients with multiple exposures to contrast media, worsening of renal function over time is associated with known risk factors for the progression of kidney disease but not with cumulative contrast volume.Doron SudarskyRobert NaamiFaheem ShehadehAdi EliasArthur KernerDoron AronsonWileyarticleacute kidney injurycontrast mediacontrast‐induced nephropathyDiseases of the circulatory (Cardiovascular) systemRC666-701ENJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease, Vol 10, Iss 18 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	acute kidney injury contrast media contrast‐induced nephropathy Diseases of the circulatory (Cardiovascular) system RC666-701
spellingShingle	acute kidney injury contrast media contrast‐induced nephropathy Diseases of the circulatory (Cardiovascular) system RC666-701 Doron Sudarsky Robert Naami Faheem Shehadeh Adi Elias Arthur Kerner Doron Aronson Risk of Worsening Renal Function Following Repeated Exposures to Contrast Media During Percutaneous Coronary Interventions
description	Background Multiple contrast media exposures are common, but their cumulative effect on renal function is unknown. We aimed to investigate the renal consequences of repeated exposures to contrast media with coronary interventions. Methods and Results We studied 2942 patients who underwent between 1 and 9 procedures. The primary end point was a persistent creatinine increase of ≥50% above baseline at ≥90 days after the last procedure. The effect of cumulative contrast media dose was assessed using Cox models, with cumulative exposure as a time‐dependent variable, and propensity score matching. The primary end point occurred in 190 patients (6.5%), with 6.1%, 6.8%, and 6.2% of patients with 1, 2 or 3, and ≥4 procedures, respectively (P=0.75). In the multivariable Cox model, baseline renal function, diabetes, anemia, acute coronary syndrome, and heart failure were independent predictors of the primary end point (all P≤0.01), whereas cumulative contrast dose was not (hazard ratio [HR], 1.29 [95% CI, 0.89–1.88] for the fourth contrast quartile [>509 mL] versus first contrast quartile [<233 mL]). Propensity score matching yielded 384 patient pairs with similar characteristics and either 1 or 2 to 9 contrast exposures (median cumulative dose, 160 and 480 mL, respectively). Despite large differences in the cumulative contrast exposure, there were similar rates of the primary end points (7.3% versus 6.3%, respectively; HR, 0.76 [95% CI, 0.44–1.32]). Conclusions In patients with multiple exposures to contrast media, worsening of renal function over time is associated with known risk factors for the progression of kidney disease but not with cumulative contrast volume.
format	article
author	Doron Sudarsky Robert Naami Faheem Shehadeh Adi Elias Arthur Kerner Doron Aronson
author_facet	Doron Sudarsky Robert Naami Faheem Shehadeh Adi Elias Arthur Kerner Doron Aronson
author_sort	Doron Sudarsky
title	Risk of Worsening Renal Function Following Repeated Exposures to Contrast Media During Percutaneous Coronary Interventions
title_short	Risk of Worsening Renal Function Following Repeated Exposures to Contrast Media During Percutaneous Coronary Interventions
title_full	Risk of Worsening Renal Function Following Repeated Exposures to Contrast Media During Percutaneous Coronary Interventions
title_fullStr	Risk of Worsening Renal Function Following Repeated Exposures to Contrast Media During Percutaneous Coronary Interventions
title_full_unstemmed	Risk of Worsening Renal Function Following Repeated Exposures to Contrast Media During Percutaneous Coronary Interventions
title_sort	risk of worsening renal function following repeated exposures to contrast media during percutaneous coronary interventions
publisher	Wiley
publishDate	2021
url	https://doaj.org/article/81edfdb1a4f7472f8e868eff00a49ef6
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Risk of Worsening Renal Function Following Repeated Exposures to Contrast Media During Percutaneous Coronary Interventions

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