Coronary Angiography Found Safe in Chronic Kidney Disease


Procedure does not reduce kidney function in high-risk patients awaiting a transplant

24 oct 2009-- Screening coronary angiography does not reduce renal function in high-risk patients with advanced chronic kidney disease awaiting a kidney transplant, according to a study published online Oct. 15 in the Clinical Journal of the American Society of Nephrology.

Nicola Kumar, from the Imperial College Kidney and Transplant Institute in London, and colleagues retrospectively determined the risk of contrast nephropathy in 76 high-risk patients with advanced chronic kidney disease (stages IV or V) who underwent screening coronary angiography.

The researchers found that the glomerular filtration rate was similar six months before and after coronary angiography. Cumulative dialysis-free survival was 89.1 percent six months after angiography, and 32.9 percent of patients received a kidney transplant, of which 88.0 percent were performed before the need for dialysis. Flow-limiting coronary artery disease was present in 30.3 percent of patients.

"The data suggest coronary angiography screening does not accelerate the decline in renal function for patients with advanced chronic kidney disease, facilitating a safe preemptive transplant program," Kumar and colleagues conclude. "If the procedure is performed appropriately with small volumes of contrast, biplane angiography using N-Acetylcysteine, and adequate hydration around the time of the procedure, then the risk of contrast exposure can be minimized in this population."

Abstract
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