title: Impact of peripheral arterial occlusive disease on the development of contrast medium-induced acute kidney injury.
abstract: OBJECTIVE
  Contrast medium-induced acute kidney injury (CI-AKI) is an important complication following the use of iodinated contrast media. It accounts for a significant number of hospital-acquired acute kidney injuries and is associated with increased in-hospital and long-term mortality and immense health care costs. We evaluated whether the presence of peripheral arterial occlusive disease (PAD) affects the incidence of CI-AKI following heart catheterization.
  
  
  METHODS
  The impact of PAD on the frequency of CI-AKI after heart catheterization was analysed in the prospective single-centre Dialysis-versus-Diuresis trial (January 2001 to July 2004). The patients were retrospectively divided into 3 subgroups: patients with coronary heart disease (CHD), patients with PAD and patients without PAD or CHD.
  
  
  RESULTS
  412 patients were included (83.5% men, 29.1% diabetes mellitus, 4.9% ejection fraction <35%). Of these, 251 (60.9%) suffered from CHD but not from PAD, 77 (18.7%) from PAD and 84 (20.4%) had neither CHD nor PAD. After heart catheterization, 49 (11.9 %) patients developed CI-AKI. Patients with PAD suffered significantly more often from CI-AKI than those without PAD (32.7 vs. 16.8%, p = 0.008). Multivariate analyses by logistic regression confirmed PAD to be an independent predictor of a CI-AKI (odds ratio 2.013, 95% confidence interval 1.009-4.016, p = 0.047). The CHD was not significantly associated with CI-AKI.
  
  
  CONCLUSIONS
  Patients with PAD significantly more often develop a CI-AKI after heart catheterization than those without PAD.
authors.affiliation: Division of Angiology, Department of Cardiology and Angiology, University Hospital of Münster, Münster, Germany. f.lueders @ gmx.net
authors.forename: Florian
authors.initials: F
authors.lastname: Lüders
authors.forename: Nasser
authors.initials: N
authors.lastname: Malyar
authors.forename: Matthias
authors.initials: M
authors.lastname: Meyborg
authors.forename: Katrin
authors.initials: K
authors.lastname: Gebauer
authors.forename: Eva
authors.initials: E
authors.lastname: Brand
authors.forename: Holger
authors.initials: H
authors.lastname: Reinecke
mesh_terms: D058186:Acute Kidney Injury / Q000139:chemically induced* / Q000453:epidemiology; D000368:Aged; D001157:Arterial Occlusive Diseases / Q000150:complications*; D003287:Contrast Media / Q000009:adverse effects*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D016491:Peripheral Vascular Diseases / Q000150:complications*; D012189:Retrospective Studies
chemical_list: D003287:Contrast Media