Small dose Contrast Venography as Venous Mapping in Predialysis Patients

Abstract

Purpose This study was designed to evaluate radiocontrast-induced nephrotoxicity (RIN), and the image quality and findings of venography using small doses of radiocontrast as a venous mapping method in pre-dialysis patients. Methods Twenty-eight patients with stage 4 and 5 chronic kidney disease underwent arm venography with 10–15 ml of dilute contrast medium. Image quality, venographic findings and glomerular filtration rate (GFR) before and after the procedure were evaluated. Results Mean GFR was 19.3±5.8 ml/min/1.73 m2 (7–30 ml/min/1.73 m2). Image quality of venography in the forearm and upper arm veins was good in all patients. Central veins were visualized well in 26 (92.8%) patients. Eight (28.5%) patients showed cephalic veins inadequate for creation of radiocephalic arteriovenous fistula (AVF) because of occlusion or small diameter veins. There was no significant difference in GFR between the pre- and post-study (19.3±5.8 vs. 19.2±6.2 ml/min/1.73 m2, p=0.693). RIN developed (GFR: 17 to 13 ml/min/1.73 m2) in only one patient but without sequelae, and the GFR completely recovered to baseline level 7 days after the study. Conclusion Small dose venography is safe and effective for venous mapping in pre-dialysis patients.