The effect of coronary angiography on residual renal function in patients on peritoneal dialysis.
BACKGROUND
The risk of intravascular radiocontrast to residual renal function (RRF) in patients on peritoneal dialysis (PD) remains largely unknown.


OBJECTIVE
This study sought to estimate the effect of coronary angiography on RRF in patients on PD.


METHODS
All patients at the VA Pittsburgh Healthcare System and University of Pittsburgh who underwent coronary angiography between 1993 and 2005 while on PD and who had RRF measured prior to angiography were identified retrospectively. For patients without a postprocedure RRF recorded, medical records were reviewed to determine whether anuria had developed. The longer-term rate of loss of RRF among cases was compared with a composite rate of decline in RRF among cases before angiography and matched controls.


RESULTS
Twenty-nine patients with a mean preprocedure RRF of 4.4+/-3.2 ml/min/1.73m(2) were evaluated. Of these patients, 23 (79%) had postangiography RRF assessments (mean clearance 3.4+/-3.0 ml/min/1.73m(2)). One of the remaining six patients definitely became permanently anuric following angiography, one was lost to follow-up, and there was no postprocedure RRF assessment in four others. The rate of decline in RRF in the cases was similar to the composite rate (0.07 ml/min/1.73m(2)/month vs. 0.09 ml/min/1.73m(2)/month, p=0.53)


CONCLUSIONS
The risk for permanent anuria in patients on PD undergoing coronary angiography appears to be quite small. Patients who do not develop anuria following coronary angiography have the same gradual rate of loss of RRF as other patients on PD. Providers should be vigilant in protecting RRF in patients on PD undergoing coronary angiography.
Weisbord
Steven D
SD
Renal Section, Medical Specialty Service Line, VA Pittsburgh Healthcare System, Pittsburgh, PA 15240, USA. weisbordsd@upmc.edu
Bernardini
Judith
J
Mor
Maria K
MK
Hartwig
Kathryn C
KC
Nicoletta
Patricia J
PJ
Palevsky
Paul M
PM
Piraino
Beth
B
D001002:Anuria / Q000209:etiology / Q000503:physiopathology; D016022:Case-Control Studies; D003287:Contrast Media / Q000009:adverse effects*; D017023:Coronary Angiography; D005260:Female; D006801:Humans; D007668:Kidney / Q000187:drug effects / Q000503:physiopathology*; D007676:Kidney Failure, Chronic / Q000503:physiopathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010414:Pennsylvania; D010530:Peritoneal Dialysis; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors
D003287:Contrast Media