Clinical Outcome of Low Dose Contrast during Percutaneous Coronary Intervention in Patients with Moderate to Severe Kidney Impairment

• 作者: Ahmed Magdy Kamal Eldin Mohamed Mahmoud Khattab Walaa Farid Abdel Aziz Wassam Eldin Elshafey
• 来源期刊: 心血管病(英文)
• 学科: 医学
• 关键词: Chronic KIDNEY Disease (CKD) Maximum Allowed CONTRAST DOSE (MACD) CONTRAST Induced Acute KIDNEY Injury (CI-AKI) Low DOSE Protocol CONTRAST Volume to e-GFR Ratio
• 年，卷（期）: 2019,（11）
• 页码范围: 781-795
• 页数: 15页
• 分类号: R69

摘要

Background: Chronic kidney disease patients are at a greater risk for nephropathy requiring dialysis after percutaneous coronary intervention. Such patients are usually deferred due to fear of “Renalism”.?Objectives This study assesses the outcome of Low dose contrast protocol during PCI in CKD patients whose e-GFR 60 ml/min/1.72 m and investigates a safety margin for contrast use in these high-risk categories.?Methods: Patients were into three groups according to CV/e-GFR ratio: Group (A) low-dose: CV/e-GFR ratio 2.0 Group (B) medium-dose: CV/e-GFR ratio > 2.0 and × bodyweight\s.creatinine). Group (C) high-dose: CV/e-GFR ratio > MACD. Results: A total of 73 patients were enrolled. Average age was 54 ± 8 years,81.4% were male and 18.6% were females and 52% were diabetic. Mean baseline e-GFR was 40 ± 8.0 ml/min/1.73m2. Contrast Volume used in group A was (58.26 ± 15.05) (n = 24), in group B (109.42 ± 17.11) (n = 26) and in group C (304.5 ± 60.30) (n = 23), respectively. The incidences of CI-AKI in the 3 groups were 0%, 11.5% and 35%, respectively (p = 0.02). All-cause death 0%, 17% and introduction of maintenance hemo dialysis was 0%, 11.5% and 26%, respectively (p Conclusion: Low dose contrast protocol is safe, effective and easily applicable technique without CI-AKI or death. CV/e-GFR