Risks for renal dysfunction with cardiac angiography.
In 139 patients with preexisting abnormal renal function (serum creatinine level of 2.0 mg/dL or greater) undergoing cardiac angiography (141 examinations), the incidence of contrast nephropathy, defined as a 1 mg/dL or greater rise in serum creatinine, was 23% (95% confidence interval, 17% to 30%). Stepwise logistic regression analysis showed that contrast nephropathy was independently associated with class IV heart failure with low cardiac output (71% incidence in this subgroup; p less than 0.0001), multiple radiocontrast studies within 72 hours (50%; p = 0.002), dose of radiocontrast administered (p = 0.009), and insulin-dependent diabetes mellitus (44%; p = 0.007). Age, hypertension, and hyperuricemia were not associated. In patients without low cardiac output, other radiocontrast tests, or insulin-dependent diabetes mellitus, there was a 2% incidence of contrast nephropathy in those who received less than 125 mL radiocontrast and a 19% incidence in those who received 125 mL or greater.
D058186:Acute Kidney Injury / Q000139:chemically induced* / Q000209:etiology; D000328:Adult; D000368:Aged; D002303:Cardiac Output, Low / Q000150:complications; D003287:Contrast Media / Q000008:administration & dosage / Q000009:adverse effects*; D017023:Coronary Angiography; D003404:Creatinine / Q000097:blood; D003922:Diabetes Mellitus, Type 1 / Q000150:complications; D004305:Dose-Response Relationship, Drug; D005260:Female; D006333:Heart Failure / Q000150:complications; D006801:Humans; D007674:Kidney Diseases / Q000097:blood / Q000150:complications; D008297:Male; D008875:Middle Aged; D012044:Regression Analysis; D012306:Risk
D003287:Contrast Media; D003404:Creatinine