Contrast-induced nephropathy following peripheral endovascular intervention and its long-term morbidity

Abstract

Background and Objectives: Contrast-induced nephropathy (CIN) is an acute deterioration of renal function seen following the administration of iodinated contrast media for various diagnostic procedures. Although extensive study has been done in various fields, the data on CIN are lacking in peripheral endovascular procedures. This study was conducted to analyze the incidence, risk factors, and long-term renal morbidity of CIN after endovascular procedure for critical limb ischemia (CLI) of lower limbs. Methods: This was a prospective, observational study and the patients undergoing peripheral endovascular procedure for CLI in a referral center were included. The patients were followed up for the development of CIN with serum creatinine levels on the 5th day postprocedure and till 6 months. Results: A total of 211 patients with various comorbidities were included. The incidence of CIN was found to be 7.5%. The risk factors and multiple comorbidities were compared between CIN and non CIN patients. The higher preprocedure creatinine (mean 1.03 mg/dl vs. 0.92 mg/dl, P < 0.045), higher contrast volume (mean 73.8 ml vs. 52.1 ml, P < 0.001), and lower hemoglobin (mean 10.5 g/dl vs. 11.8 g/dl, P < 0.008) were significantly associated with CIN. The follow-up at 6 months showed CIN patients had increased serum creatinine and reduced estimated glomerular filtration rate as compared to non-CIN patients. Conclusion: CIN is a substantial problem in peripheral endovascular procedures with long-term renal morbidity. The strategies to prevent CIN should be included in all patients undergoing endovascular procedures irrespective of risk profile and long-term renal function monitoring of CIN patients is warranted.

Keywords

• contrast-induced nephropathy
• peripheral endovascular procedures
• renal morbidity