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, Division of Vascular and Interventional Radiology, Mayo Clinic, Minnesota, USA  
Diagn Interv Radiol 2018; 24: 378-384
DOI: 10.5152/dir.2018.18172
Abstract

PURPOSE: We aimed to determine the incidence rate and potential risk factors for postcontrast 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.


METHODS: This retrospective study reviewed 412 patients with CKD who underwent renal artery stent placement. Sixty-eight patients underwent intervention exclusively with gadolinium-based contrast agents 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 glomerular filtration rate ( GFR, odds ratio [OR]=0.91, P = 0.047). Prehydration was associated with a lower PC-AKI rate (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.

 

You may cite this article as: Takahashi EA, Kallmes DF, Mara KC, Harmsen WS, Misra S. Nephrotoxicity of gadolinium-based contrast in the setting of renal artery intervention: retrospective analysis with 10-year follow-up. Diagn Interv Radiol 2018; 24:378–384.

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