E-ISSN 1305-3612
Interventional Radiology - Original Article
Nephrotoxicity of gadolinium-based contrast in the setting of renal artery intervention: retrospective analysis with 10-year follow-up
1 Department of Radiology, Mayo Clinic, , Minnesota, USA  
2 Department of Clinical Statistics, Mayo Clinic, Minnesota, USA  
3 Department of Radiology, Mayo Clinic, Department of Clinical Statistics, Mayo Clinic, Minnesota, USA  
4 Department of Radiology, Mayo Clinic; Division of Vascular and Interventional Radiology, Mayo Clinic, Minnesota, USA  
Diagn Interv Radiol ; : -

Abstract

 

PURPOSE: To determine the incidence rate and potential risk factors for post-contrast acute kidney injury (PC-AKI) as well as the long-term clinical implications on dialysis and mortality in patients with chronic kidney disease (CKD) who underwent renal artery stent placement exclusively with gadolinium-based contrast agents (GBCA).

 

METHODS: This retrospective study reviewed 412 patients with CKD who underwent renal artery stent placement. Sixty-eight patients underwent intervention exclusively with GBCA and were analyzed. Criteria for PC-AKI included either an absolute serum creatinine increase > 0.3 mg/dL or percentage increase in serum creatinine > 50% within 48 hours of intervention. Logistic regression analysis was performed to identify risk factors for PC-AKI. The cumulative proportion of patients who died or went on to hemodialysis was determined using Kaplan-Meier survival analysis.

 

RESULTS: The incidence of PC-AKI was 14.7%. The rate of AKI decreased for every 1 unit increase in GFR (Odds ratio [OR]=0.91; P = 0.047). Prehydration was associated with a lower PC-AKI rates (OR=0.17, P=0.015). Acute kidney injury after intervention was associated with an increased rate of dialysis (Hazard ratio [HR]=4.51, P=0.002) and mortality (HR=2.52; P=0.027).

 

CONCLUSION: Gadolinium-based contrast agents are potentially nephrotoxic when used for endovascular intervention in patients with CKD. The risk of PC-AKI increased with lower GFR and decreased with prehydration. Dialysis and mortality risk were increased in patients who developed PC-AKI.

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