E-ISSN: 1305-3612
    Nephrotoxicity of gadolinium-based contrast in the setting of renal artery intervention: retrospective analysis with 10-year follow-up
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    Interventional Radiology - Original Article
    VOLUME: 24 ISSUE: 6
    P: 378-384
    November 2018

    Nephrotoxicity of gadolinium-based contrast in the setting of renal artery intervention: retrospective analysis with 10-year follow-up

    Diagn Interv Radiol 2018;24(6):378-384
    DOI: 10.5152/dir.2018.18172
    Edwin A. Takahashi 1
    David F. Kallmes 1
    Kristin C. Mara 2
    William S. Harmsen 3
    Sanjay Misra 4
    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
    No information available.
    No information available
    Received Date: 17.04.2018
    Accepted Date: 22.05.2018
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    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.

    References

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