[Protection of renal function during interventional diagnostic or therapeutic procedures in coronary heart disease patients complicated by chronic renal insufficiency].
OBJECTIVE
To evaluate the safety and efficacy of protective measures for renal function during interventional procedures in patients with chronic renal insufficiency.


METHODS
Changes in renal function in 90 patients of coronary artery disease with chronic renal insufficiency admitted from January 1994 to July 2002 during intraoperative intervention were analyzed. These patients were divided into three groups: in group A patients underwent coronary angiography (SCA) with conventional peri-intervention treatment; in group B patients underwent SCA and treated with low dose dopamine plus saline hydration peri-intervention; in group C patients underwent percutaneous transluminal coronary angioplasty (PTCA) and stenting, and treated with low dose dopamine plus saline hydration during peri-intervention.


RESULTS
Coronary intervention was successful in all patients of three groups. Contrast medium-associated nephropathy (CAN) was found in 28 patients after the procedures, and them 11 occurred in group A (36.7%), 5 in group B (16.7%), and 12 in group C (40.0%), respectively. The incidence of CAN was highest in group C, and lowest in group B (P<0.01). All patients recovered and discharged after medical treatment, and no hemodialysis was necessary. Higher incidence of CAN was found in patients with congestive heart failure than patients without heart failure (64.5%, 20/31 cases vs. 13.6%, 8/59 cases; P<0.01), and also higher incidence of CAN was found in diabetic patients than non-diabetic patients (42.6 , 23/54 cases vs. 13.9%, 5/36 cases; P<0.01).


CONCLUSIONS
The patients with coronary artery disease with chronic renal insufficiency are able to tolerate the interventional procedures well with safety and ideal prognosis, if they are properly protected with dopamine and fluid during the procedure.
Han
Ya-ling
YL
Department of Cardiology, General Hospital of Shenyang Command, Shenyang 110016, Liaoning, China.
Zang
Hong-yun
HY
Jing
Quan-min
QM
Wang
Shou-li
SL
Wang
Dong-mei
DM
Wang
Zu-lu
ZL
D015906:Angioplasty, Balloon, Coronary; D017023:Coronary Angiography; D003327:Coronary Disease / Q000150:complications / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000628:therapy*; D005260:Female; D006801:Humans; D007668:Kidney / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D051436:Renal Insufficiency, Chronic / Q000150:complications* / Q000503:physiopathology; D015607:Stents