title: Contrast-induced nephropathy following chronic total occlusion percutaneous coronary intervention in patients with chronic kidney disease.
abstract: OBJECTIVE
  Contrast-induced nephropathy (CIN) has not been systematically studied in high-risk patients with chronic kidney disease (CKD) undergoing percutaneous coronary intervention (PCI) for chronic total occlusion (CTO).
  
  
  METHODS
  We prospectively observed 515 consecutive patients with CKD undergoing PCI. Patients were divided into three groups: patients who underwent attempted PCI for CTO (group A, n = 85), patients who did not receive PCI for CTO (group B, n = 45) and patients without CTO (group C, n = 385).
  
  
  RESULTS
  CIN developed in 55 patients (10.68 %). Group A patients received a larger CM dose than group B or group C (p = 0.024). The intravenous hydration volume, age and CIN Mehran score were not significantly different between the three groups. The incidence of CIN was 9.4 % for group A, 6.7 % for group B and 11.4 % for group C (p = 0.344). In-hospital mortality and required renal replacement therapy (p = 0.325) were not significantly different between the groups. Multivariate analysis showed that after adjusting for potential confounding factors, the odds ratio for CIN was 1.03 (p = 0.944) for group A and 0.64 for group B (p = 0.489) compared to group C.
  
  
  CONCLUSIONS
  Attempts to achieve recanalization of CTO in patients with CKD might not increase the risk of CIN if appropriate preventative measures are taken.
  
  
  CONCLUSIONS
  • Contrast-induced nephropathy can increase morbidity and mortality • Chronic kidney disease patients are at the greatest risk of CIN • Patients with CKD undergoing CTO-PCI are common • Incidence of CIN has not been reported in CKD patients • CTO-PCI in CKD patients might not increase the risk of CIN.
authors.affiliation: Southern Medical University, Guangzhou, 510515, Guangdong, China.
authors.forename: Yuan-Hui
authors.initials: YH
authors.lastname: Liu
authors.forename: Yong
authors.initials: Y
authors.lastname: Liu
authors.forename: Ning
authors.initials: N
authors.lastname: Tan
authors.forename: Ji-Yan
authors.initials: JY
authors.lastname: Chen
authors.forename: Ying-Ling
authors.initials: YL
authors.lastname: Zhou
authors.forename: Jian-Fang
authors.initials: JF
authors.lastname: Luo
authors.forename: Dan-Qing
authors.initials: DQ
authors.lastname: Yu
authors.forename: Li-Wen
authors.initials: LW
authors.lastname: Li
authors.forename: Hua-Long
authors.initials: HL
authors.lastname: Li
authors.forename: Piao
authors.initials: P
authors.lastname: Ye
authors.forename: Peng
authors.initials: P
authors.lastname: Ran
mesh_terms: D058186:Acute Kidney Injury / Q000139:chemically induced*; D000368:Aged; D003287:Contrast Media / Q000009:adverse effects*; D054059:Coronary Occlusion / Q000601:surgery*; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007472:Iohexol / Q000009:adverse effects / Q000031:analogs & derivatives; D007479:Iopamidol / Q000009:adverse effects; D008297:Male; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects*; D011446:Prospective Studies; D051436:Renal Insufficiency, Chronic / Q000150:complications*; D012307:Risk Factors
chemical_list: D003287:Contrast Media; D007472:Iohexol; C038192:iopromide; D007479:Iopamidol