Contrast medium nephrotoxicity after renal artery and coronary angioplasty

Abstract

Background: Renal dysfunction induced by iodinated contrast medium (CM) administration can minimize the benefit of the interventional procedure in patients undergoing renal angioplasty (PTRA). Purpose: To compare the susceptibility to nephrotoxic effect of CM in patients undergoing PTRA with that of patients submitted to percutaneous coronary intervention (PCI). Material and Methods: A total of 33 patients successfully treated with PTRA (PTRA group, mean age 70±12 years, 23 female, basal creatinine 1.46±0.79, range 0.7–4.9 mg/dl) were compared with 33 patients undergoing successful PCI (PCI group), matched for basal creatinine (1.44±0.6, range 0.7–3.4 mg/dl), gender, and age. In both groups postprocedural (48 h) serum creatinine was measured. Results: Postprocedural creatinine level decreased nonsignificantly in the PTRA group (1.46±0.8 vs. 1.34±0.5 mg/dl, P=NS) and increased significantly in the PCI group (1.44±0.6 vs. 1.57±0.7 mg/dl, P<0.02). Changes in serum creatinine after intervention (after-before) were significantly different between the PTRA and PCI groups (−0.12±0.5 vs. 0.13±0.3, P=0.014). This difference was not related to either a different clinical risk profile or to the volume of CM administered. Conclusion: In this preliminary study patients submitted to PTRA showed a lower susceptibility to renal damage induced by CM administration than PCI patients. The effectiveness of PTRA on renal function seems to be barely influenced by CM toxicity.