Predicting renal failure after balloon angioplasty in high-risk patients.
OBJECTIVE
To assess the incidence and predictors of acute renal failure after percutaneous transluminal angioplasty (PTA) in a cohort of patients with generalized atherosclerosis.


METHODS
A retrospective review of 213 consecutive patients (127 men; median age 71 years, interquartile range 63-77) undergoing femoropopliteal PTA was undertaken. Renal function was measured by creatinine clearance at baseline and 24 hours after the intervention; acute renal dysfunction was defined as > or = 20% decrease of creatinine clearance. The predictive value of potential risk factors was determined in a multivariate model adjusting for comorbidities, pre-existing renal impairment, and angiographic data.


RESULTS
Overall serum creatinine values and creatinine clearance remained stable within 24 hours after PTA. Acute renal dysfunction occurred in 25 (12%) patients. Two (1%) patients developed oliguria; one required transient hemodialysis and developed persistent renal failure. Pre-existing impaired renal function (OR 12.2, p < 0.0001) and contrast dosage (OR 1.1, p = 0.03) were independent predictors of acute renal failure; hypertension (OR 7.9, p = 0.06) and congestive heart failure (OR 4.5, p = 0.06) were associated factors.


CONCLUSIONS
While transient acute renal dysfunction occurs in approximately 10% of patients with peripheral artery disease within 24 hours after angioplasty, persistent renal failure or end-stage renal disease is rare.
Schillinger
M
M
Department of Internal Medicine II, University of Vienna Medical School, Austria. martin.schillinger@akh-wien.ac.at
Haumer
M
M
Mlekusch
W
W
Schlerka
G
G
Ahmadi
R
R
Minar
E
E
D058186:Acute Kidney Injury / Q000175:diagnosis / Q000209:etiology*; D000368:Aged; D000800:Angioplasty, Balloon / Q000009:adverse effects* / Q000379:methods; D001161:Arteriosclerosis / Q000150:complications*; D015415:Biomarkers / Q000097:blood; D015331:Cohort Studies; D003404:Creatinine / Q000097:blood; D005260:Female; D005263:Femoral Artery; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D011150:Popliteal Artery; D012044:Regression Analysis; D012189:Retrospective Studies; D012307:Risk Factors
D015415:Biomarkers; D003404:Creatinine