Contrast Induced Nephropathy and Long-term Renal Decline After Percutaneous Transluminal Angioplasty for Symptomatic Peripheral Arterial Disease

T. A. Sigterman*, A. G. Krasznai, M. G. Snoeijs, R. Heijboer, G. W. H. Schurink, L. H. Bouwman

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

28 Citations (Web of Science)

Abstract

Objective/background: Administration of iodinated contrast media during endovascular procedures for peripheral arterial disease (PAD) may cause contrast induced nephropathy (CIN). The aim of the present study was to establish the incidence of CIN after these procedures and to study its association with long-term loss of kidney function, cardiovascular events, and death. Methods: Consecutive patients first presenting with symptomatic PAD (Rutherford classification II-VI) who were treated with an endovascular procedure were included in this prospectiye observational cohort study. CIN was defined as >25% increase of serum creatinine concentration from baseline at 5 days after the intervention. Results: Some 337 patients were included with a mean estimated glomerular filtration rate (eGFR) of 67 mL/minute. Thirteen percent (95% confidence interval [CI] 9-16) of these patients developed CIN after endovascular interventions for PAD. One year after treatment, eGFR was reduced by 12.4 mL/minute (95% CI 8.6-16.2) in patients with CIN compared with 6.2 mL/minute (95% CI 4.9-7.0) in patients without acute kidney injury (p <.01). After correction for potential confounders, CIN was associated with a 7.8 mL/minute (95% CI 4.5-11.0) reduction of eGFR at 1 year after endovascular intervention (p <.01). Furthermore, patients with CIN were at increased risk of long-term cardiovascular events and mortality. Conclusion: Exposure to iodinated contrast media during endovascular procedures for symptomatic PAD frequently results in CIN. Patients with CIN are at increased risk of long-term loss of renal function, cardiovascular events, and death.
Original languageEnglish
Pages (from-to)386-393
JournalEuropean Journal of Vascular and Endovascular Surgery
Volume51
Issue number3
DOIs
Publication statusPublished - Mar 2016

Keywords

  • Contrast induced nephropathy
  • Cardiovascular events
  • Endovascular interventions
  • Mortality
  • Peripheral arterial disease
  • Renal decline

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