title: Adrenal venous sampling for primary hyperaldosteronism in patients with concurrent chronic kidney disease.
abstract: OBJECTIVE
  To assess the risk of developing contrast-induced nephropathy (CIN) and to evaluate the technical success of adrenal venous sampling (AVS) in patients with chronic kidney disease (CKD).
  
  
  METHODS
  AVS was performed in 25 patients with primary hyperaldosteronism and concurrent CKD to distinguish between unilateral and bilateral adrenal disease. One of the 25 patients underwent repeat AVS, for a total of 26 samplings. All patients received a hydration protocol before and after the procedure. Acute kidney injury (AKI) (increase in creatinine of 0.5 mg/dL or>25% above baseline) and diagnostic yield were determined.
  
  
  RESULTS
  CKD was stage III in 20 patients (80%), stage IV in 4 patients (16%), and stage V in 1 patient (4%). Median contrast volume was 25 mL (range, 10-250 mL). Of 26 studies, 25 (96%) were diagnostic; the one nondiagnostic AVS was repeated with success. Despite their elevated risks, only 2 of 25 patients (8%) developed AKI, and neither patient required treatment.
  
  
  CONCLUSIONS
  AVS can be performed safely with a high degree of technical success and low risk of CIN in patients with primary hyperaldosteronism and concurrent advanced CKD.
authors.affiliation: Department of Radiology, Division of Interventional Radiology, University of Pennsylvania Medical Center, Philadelphia, PA 19104, USA.
authors.forename: Mark
authors.initials: M
authors.lastname: Burshteyn
authors.forename: Debbie L
authors.initials: DL
authors.lastname: Cohen
authors.forename: Douglas L
authors.initials: DL
authors.lastname: Fraker
authors.forename: Scott O
authors.initials: SO
authors.lastname: Trerotola
mesh_terms: D058186:Acute Kidney Injury / Q000209:etiology; D000311:Adrenal Glands / Q000098:blood supply / Q000378:metabolism*; D003404:Creatinine / Q000097:blood*; D005260:Female; D006801:Humans; D006929:Hyperaldosteronism / Q000097:blood* / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D018962:Phlebotomy / Q000009:adverse effects / Q000379:methods*; D051436:Renal Insufficiency, Chronic / Q000097:blood* / Q000175:diagnosis*; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity
chemical_list: D003404:Creatinine