Percutaneous coronary interventions in the high-risk renal patient: strategies for renal protection and vascular protection.
CKD is the most important factor in predict-ing adverse short- and long-term outcomes after PCI. Hence, the rationale for renal end-organ protection is based on chronic renal protection,avoidance of additive renal insults, and a comprehensive CIN prophylaxis. The pathogenesis of CIN goes beyond serum creatinine and involves a unique vascular pathobiology in which interrelates renal and CVD outcomes are interrelated. Attempts at PCI in patients with CKD and ESRD are high-risk procedures, but the risks involved seem to be warranted given comparative outcomes in conservatively treated patients. The benefits of short- and long-term vascular protective therapies in CKD patients have been confirmed, and these therapies are an important component of PCI care.
McCullough
Peter A
PA
Divisions of Cardiology, Nutrition and Preventive Medicine, Department of Medicine, William Beaumont Hospital, 4949 Coolidge, Royal Oak, MI 48073, USA. pmc975@yahoo.com
Berman
Aaron D
AD
D015906:Angioplasty, Balloon, Coronary; D002908:Chronic Disease; D003287:Contrast Media / Q000009:adverse effects; D003324:Coronary Artery Disease / Q000209:etiology* / Q000628:therapy*; D006801:Humans; D007674:Kidney Diseases / Q000139:chemically induced / Q000150:complications* / Q000517:prevention & control; D012307:Risk Factors; D016896:Treatment Outcome
D003287:Contrast Media