Small dose contrast venography as venous mapping in predialysis patients.
OBJECTIVE
This study was designed to evaluate radiocontrast-induced nephrotoxicity (RIN), and the image quality and findings of venography using small doses of radiocontrast as a venous mapping method in pre-dialysis patients.


METHODS
Twenty-eight patients with stage 4 and 5 chronic kidney disease underwent arm venography with 10-15 ml of dilute contrast medium. Image quality, venographic findings and glomerular filtration rate (GFR) before and after the procedure were evaluated.


RESULTS
Mean GFR was 19.3+/-5.8 ml/min/1.73 m2 (7-30 ml/min/1.73 m2). Image quality of venography in the forearm and upper arm veins was good in all patients. Central veins were visualized well in 26 (92.8%) patients. Eight (28.5%) patients showed cephalic veins inadequate for creation of radiocephalic arteriovenous fistula (AVF) because of occlusion or small diameter veins. There was no significant difference in GFR between the pre- and post-study (19.3+/-5.8 vs. 19.2+/-6.2 ml/min/1.73 m2, p=0.693). RIN developed (GFR: 17 to 13 ml/min/1.73 m2) in only one patient but without sequelae, and the GFR completely recovered to baseline level 7 days after the study.


CONCLUSIONS
Small dose venography is safe and effective for venous mapping in pre-dialysis patients.
Won
Yoo Dong
YD
Department of Radiology, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Lee
Ja Young
JY
Shin
Young Shin
YS
Kim
Young Soo
YS
Yoon
Sun Ae
SA
Kim
Yong Soo
YS
Hahn
Seong Tai
ST
Park
Sun Cheol
SC
Kim
Young Ok
YO
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001132:Arm / Q000098:blood supply*; D001166:Arteriovenous Shunt, Surgical; D002908:Chronic Disease; D003287:Contrast Media / Q000008:administration & dosage / Q000009:adverse effects; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007674:Kidney Diseases / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000628:therapy; D008297:Male; D008875:Middle Aged; D010690:Phlebography / Q000009:adverse effects / Q000379:methods*; D011237:Predictive Value of Tests; D011300:Preoperative Care; D011446:Prospective Studies; D006435:Renal Dialysis; D056910:Republic of Korea
D003287:Contrast Media