Document Detail


Safety of low volume iodinated contrast administration for arteriovenous fistula intervention in chronic kidney disease stage 4 or 5 utilizing a bicarbonate prophylaxis strategy.
MedLine Citation:
PMID:  21175838     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Efforts to increase the number of functioning arteriovenous fistulas in chronic kidney disease (CKD) stages 4 and 5 have been impacted by concerns about the risk for contrast-induced nephropathy during diagnostic and interventional procedures for poorly developed fistulas. We conducted a prospective observational study of low volume iodinated contrast administration for fistulography and angioplasty in a CKD stage 4 and stage 5 population pretreated with a sodium bicarbonate protocol. Acute kidney injury was assessed by change in serum creatinine and urinary neutrophil-gelatinase associated lipocalcin (NGAL). Only 1/18 patients (5.5%) developed acute kidney injury as defined by change in serum creatinine 48 hours after contrast exposure. No patients demonstrated significant change in urinary NGAL at 3 or 48 hours after procedure, nor did any require acute initiation of dialysis. Fistulography alone, or with angioplasty, utilizing a low volume of iodinated contrast and sodium bicarbonate solution for prophylaxis, appears to be safe in the CKD stages 4 and 5 population.
Authors:
Elizabeth Eisenhart; Scott Benson; Patricia Lacombe; Jonathan Himmelfarb; Robert Zimmerman; Brad Schimelman; Mark G Parker
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Seminars in dialysis     Volume:  23     ISSN:  1525-139X     ISO Abbreviation:  Semin Dial     Publication Date:    2010 Nov-Dec
Date Detail:
Created Date:  2010-12-23     Completed Date:  2011-05-17     Revised Date:  2011-06-13    
Medline Journal Info:
Nlm Unique ID:  8911629     Medline TA:  Semin Dial     Country:  United States    
Other Details:
Languages:  eng     Pagination:  638-42     Citation Subset:  IM    
Copyright Information:
© 2010 Wiley Periodicals, Inc.
Affiliation:
Division of Nephrology, Maine Medical Center, Portland, Maine 04102, USA.
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MeSH Terms
Descriptor/Qualifier:
Acute Kidney Injury / chemically induced,  prevention & control*,  urine
Aged
Arteriovenous Shunt, Surgical / methods*
Bicarbonates / therapeutic use*
Contrast Media / administration & dosage*,  adverse effects,  pharmacokinetics
Dose-Response Relationship, Drug
Female
Follow-Up Studies
Humans
Injections, Intravenous
Kidney Failure, Chronic / radiography,  therapy*,  urine
Male
Prognosis
Prospective Studies
Renal Dialysis / methods*
Severity of Illness Index
Triiodobenzoic Acids / administration & dosage*,  adverse effects,  pharmacokinetics
Chemical
Reg. No./Substance:
0/Bicarbonates; 0/Contrast Media; 0/Triiodobenzoic Acids; 87771-40-2/ioversol

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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