The impact of coronary angiography on renal transplant function
Abstract Introduction There may be reluctance to perform coronary angiography in kidney transplant patients due to perceived risk of iodinated contrast, despite an increased risk of cardiovascular disease compared with the general population. Aim We sought to determine if renal transplant function w...
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Veröffentlicht in: | QJM : An International Journal of Medicine 2019-01, Vol.112 (1), p.23-27 |
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creator | Lees, J S Findlay, M D Mark, P B Geddes, C C |
description | Abstract
Introduction
There may be reluctance to perform coronary angiography in kidney transplant patients due to perceived risk of iodinated contrast, despite an increased risk of cardiovascular disease compared with the general population.
Aim
We sought to determine if renal transplant function was adversely affected within 7, 30 and 180 days of coronary angiography.
Design and methods
Renal transplant recipients undergoing coronary angiography in a single centre (01/2006–02/2018) were identified retrospectively. Baseline and highest SCr within 7, 30 and 180 days of coronary angiography were extracted from the electronic patient record. Rise in creatinine >26 micromol/l was considered significant [equivalent to Acute Kidney Injury (AKI) Network criteria stage 1 AKI] and case note review performed to determine circumstance of renal decline.
Results
There were 127 coronary angiographies conducted in 90 patients: 67.7% were male and mean age was 58.0 (±10.1) years. There was AKI within 7 days in 18.9% cases, but SCr returned to baseline within 7 days or there was an alternative explanation for AKI in 83.3% of these. In the remaining four cases, there was progressive decline in renal transplant function. In the absence of critical illness, no patient required dialysis or extended hospital stay for contrast-associated AKI.
Conclusions
In this cohort of renal transplant recipients undergoing coronary angiography, AKI occurred in a minority of cases, and in more than 95% of such cases this effect was transient, with progressive renal decline a rare and predictable event. Renal transplant should not be regarded as a contraindication to coronary angiography. |
doi_str_mv | 10.1093/qjmed/hcy216 |
format | Article |
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Introduction
There may be reluctance to perform coronary angiography in kidney transplant patients due to perceived risk of iodinated contrast, despite an increased risk of cardiovascular disease compared with the general population.
Aim
We sought to determine if renal transplant function was adversely affected within 7, 30 and 180 days of coronary angiography.
Design and methods
Renal transplant recipients undergoing coronary angiography in a single centre (01/2006–02/2018) were identified retrospectively. Baseline and highest SCr within 7, 30 and 180 days of coronary angiography were extracted from the electronic patient record. Rise in creatinine >26 micromol/l was considered significant [equivalent to Acute Kidney Injury (AKI) Network criteria stage 1 AKI] and case note review performed to determine circumstance of renal decline.
Results
There were 127 coronary angiographies conducted in 90 patients: 67.7% were male and mean age was 58.0 (±10.1) years. There was AKI within 7 days in 18.9% cases, but SCr returned to baseline within 7 days or there was an alternative explanation for AKI in 83.3% of these. In the remaining four cases, there was progressive decline in renal transplant function. In the absence of critical illness, no patient required dialysis or extended hospital stay for contrast-associated AKI.
Conclusions
In this cohort of renal transplant recipients undergoing coronary angiography, AKI occurred in a minority of cases, and in more than 95% of such cases this effect was transient, with progressive renal decline a rare and predictable event. Renal transplant should not be regarded as a contraindication to coronary angiography.</description><identifier>ISSN: 1460-2725</identifier><identifier>EISSN: 1460-2393</identifier><identifier>DOI: 10.1093/qjmed/hcy216</identifier><identifier>PMID: 30295913</identifier><language>eng</language><publisher>England: Oxford University Press</publisher><subject>Acute Kidney Injury - epidemiology ; Acute Kidney Injury - etiology ; Aged ; Contrast Media - adverse effects ; Coronary Angiography - adverse effects ; Creatinine - blood ; Female ; Glomerular Filtration Rate ; Humans ; Kidney Transplantation ; Male ; Middle Aged ; Retrospective Studies ; Risk Assessment ; Risk Factors ; United Kingdom</subject><ispartof>QJM : An International Journal of Medicine, 2019-01, Vol.112 (1), p.23-27</ispartof><rights>The Author(s) 2018. Published by Oxford University Press on behalf of the Association of Physicians. All rights reserved. For permissions, please email: journals.permissions@oup.com 2018</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c361t-d19b59a36e640fb6008d7d71d511615b4caced90c20aa4d98b937a0137eee80b3</citedby><cites>FETCH-LOGICAL-c361t-d19b59a36e640fb6008d7d71d511615b4caced90c20aa4d98b937a0137eee80b3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,1584,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30295913$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Lees, J S</creatorcontrib><creatorcontrib>Findlay, M D</creatorcontrib><creatorcontrib>Mark, P B</creatorcontrib><creatorcontrib>Geddes, C C</creatorcontrib><title>The impact of coronary angiography on renal transplant function</title><title>QJM : An International Journal of Medicine</title><addtitle>QJM</addtitle><description>Abstract
Introduction
There may be reluctance to perform coronary angiography in kidney transplant patients due to perceived risk of iodinated contrast, despite an increased risk of cardiovascular disease compared with the general population.
Aim
We sought to determine if renal transplant function was adversely affected within 7, 30 and 180 days of coronary angiography.
Design and methods
Renal transplant recipients undergoing coronary angiography in a single centre (01/2006–02/2018) were identified retrospectively. Baseline and highest SCr within 7, 30 and 180 days of coronary angiography were extracted from the electronic patient record. Rise in creatinine >26 micromol/l was considered significant [equivalent to Acute Kidney Injury (AKI) Network criteria stage 1 AKI] and case note review performed to determine circumstance of renal decline.
Results
There were 127 coronary angiographies conducted in 90 patients: 67.7% were male and mean age was 58.0 (±10.1) years. There was AKI within 7 days in 18.9% cases, but SCr returned to baseline within 7 days or there was an alternative explanation for AKI in 83.3% of these. In the remaining four cases, there was progressive decline in renal transplant function. In the absence of critical illness, no patient required dialysis or extended hospital stay for contrast-associated AKI.
Conclusions
In this cohort of renal transplant recipients undergoing coronary angiography, AKI occurred in a minority of cases, and in more than 95% of such cases this effect was transient, with progressive renal decline a rare and predictable event. Renal transplant should not be regarded as a contraindication to coronary angiography.</description><subject>Acute Kidney Injury - epidemiology</subject><subject>Acute Kidney Injury - etiology</subject><subject>Aged</subject><subject>Contrast Media - adverse effects</subject><subject>Coronary Angiography - adverse effects</subject><subject>Creatinine - blood</subject><subject>Female</subject><subject>Glomerular Filtration Rate</subject><subject>Humans</subject><subject>Kidney Transplantation</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Retrospective Studies</subject><subject>Risk Assessment</subject><subject>Risk Factors</subject><subject>United Kingdom</subject><issn>1460-2725</issn><issn>1460-2393</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kD1PwzAQhi0EoqWwMSNvLITexYkTTwhVfEmVWMocXWynSZXawUmH_ntaQleme3V69OruYewW4RFBifn3ZmvNvNb7GOUZm2IiIYqFEuennMXphF31_QYAkizJL9lEQKxShWLKnla15c22Iz1wX3Htg3cU9pzcuvHrQF29597xYB21fAjk-q4lN_Bq5_TQeHfNLipqe3vzN2fs6_VltXiPlp9vH4vnZaSFxCEyqMpUkZBWJlCVEiA3mcnQpIgS0zLRpK1RoGMgSozKSyUyAhSZtTaHUszYw9irg-_7YKuiC832cGmBUBw9FL8eitHDAb8b8W5XHtcn-PT4AbgfAb_r_q_6AW5HaIk</recordid><startdate>20190101</startdate><enddate>20190101</enddate><creator>Lees, J S</creator><creator>Findlay, M D</creator><creator>Mark, P B</creator><creator>Geddes, C C</creator><general>Oxford University Press</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope></search><sort><creationdate>20190101</creationdate><title>The impact of coronary angiography on renal transplant function</title><author>Lees, J S ; Findlay, M D ; Mark, P B ; Geddes, C C</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c361t-d19b59a36e640fb6008d7d71d511615b4caced90c20aa4d98b937a0137eee80b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Acute Kidney Injury - epidemiology</topic><topic>Acute Kidney Injury - etiology</topic><topic>Aged</topic><topic>Contrast Media - adverse effects</topic><topic>Coronary Angiography - adverse effects</topic><topic>Creatinine - blood</topic><topic>Female</topic><topic>Glomerular Filtration Rate</topic><topic>Humans</topic><topic>Kidney Transplantation</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Retrospective Studies</topic><topic>Risk Assessment</topic><topic>Risk Factors</topic><topic>United Kingdom</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Lees, J S</creatorcontrib><creatorcontrib>Findlay, M D</creatorcontrib><creatorcontrib>Mark, P B</creatorcontrib><creatorcontrib>Geddes, C C</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><jtitle>QJM : An International Journal of Medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Lees, J S</au><au>Findlay, M D</au><au>Mark, P B</au><au>Geddes, C C</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The impact of coronary angiography on renal transplant function</atitle><jtitle>QJM : An International Journal of Medicine</jtitle><addtitle>QJM</addtitle><date>2019-01-01</date><risdate>2019</risdate><volume>112</volume><issue>1</issue><spage>23</spage><epage>27</epage><pages>23-27</pages><issn>1460-2725</issn><eissn>1460-2393</eissn><abstract>Abstract
Introduction
There may be reluctance to perform coronary angiography in kidney transplant patients due to perceived risk of iodinated contrast, despite an increased risk of cardiovascular disease compared with the general population.
Aim
We sought to determine if renal transplant function was adversely affected within 7, 30 and 180 days of coronary angiography.
Design and methods
Renal transplant recipients undergoing coronary angiography in a single centre (01/2006–02/2018) were identified retrospectively. Baseline and highest SCr within 7, 30 and 180 days of coronary angiography were extracted from the electronic patient record. Rise in creatinine >26 micromol/l was considered significant [equivalent to Acute Kidney Injury (AKI) Network criteria stage 1 AKI] and case note review performed to determine circumstance of renal decline.
Results
There were 127 coronary angiographies conducted in 90 patients: 67.7% were male and mean age was 58.0 (±10.1) years. There was AKI within 7 days in 18.9% cases, but SCr returned to baseline within 7 days or there was an alternative explanation for AKI in 83.3% of these. In the remaining four cases, there was progressive decline in renal transplant function. In the absence of critical illness, no patient required dialysis or extended hospital stay for contrast-associated AKI.
Conclusions
In this cohort of renal transplant recipients undergoing coronary angiography, AKI occurred in a minority of cases, and in more than 95% of such cases this effect was transient, with progressive renal decline a rare and predictable event. Renal transplant should not be regarded as a contraindication to coronary angiography.</abstract><cop>England</cop><pub>Oxford University Press</pub><pmid>30295913</pmid><doi>10.1093/qjmed/hcy216</doi><tpages>5</tpages><oa>free_for_read</oa></addata></record> |
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source | MEDLINE; Oxford University Press Journals All Titles (1996-Current); EZB-FREE-00999 freely available EZB journals; Alma/SFX Local Collection |
subjects | Acute Kidney Injury - epidemiology Acute Kidney Injury - etiology Aged Contrast Media - adverse effects Coronary Angiography - adverse effects Creatinine - blood Female Glomerular Filtration Rate Humans Kidney Transplantation Male Middle Aged Retrospective Studies Risk Assessment Risk Factors United Kingdom |
title | The impact of coronary angiography on renal transplant function |
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