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Length of Preprocedure Fasting Was Associated With Contrast Associated-Acute Kidney Injury in High-Risk Patients Undergoing Coronary Angiography
- Source :
- The American journal of cardiology. 159
- Publication Year :
- 2021
-
Abstract
- Hydration is recommended to prevent contrast associated-acute kidney injury (CA-AKI) but interactions between blood pressure, left ventricular end diastolic pressure (LVEDP) and hydration status on CA-AKI are incompletely understood. This analysis presents the results of a single-center prospective study of patients undergoing coronary angiography with a predicted risk of CA-AKI >14%. 146 patients were enrolled with a mean (±SD) age of 71 ± 11 years; 94 (64.4%) were men, 142 (97.3%) had hypertension, 96 (65.8%) had diabetes mellitus and the mean (SD) serum creatinine was 1.21 ± 0.36 mg/dl. CA-AKI occurred in 31 (21%) patients. There were no significant differences in demographics, comorbidities, renal function, LVEDP, systolic blood pressure, diastolic blood pressure, heart rate, mean arterial pressure or pulse pressure in patients who developed versus those who did not develop CA-AKI. There was no association between the amount of peri-procedure intravenous fluids and change in creatinine postprocedure. In multivariate analysis, hemoglobin, the time that the patient was fasting from solids (NPO time), and contrast volume were associated with the development of CA-AKI. There was a highly significant interaction (p = 0.0028) between the amount of intravenous fluids, NPO time and contrast volume and changes in postprocedure creatinine. In summary, hemoglobin, NPO time and contrast volume, but not hemodynamic variables, correlated with worsening renal function following coronary angiography in this population of high-risk patients. Results suggested that intravenous hydration is important in subgroups of patients depending on NPO time and contrast volume.
- Subjects :
- Mean arterial pressure
medicine.medical_specialty
Time Factors
Renal function
Hemodynamics
Contrast Media
Coronary Angiography
Risk Assessment
chemistry.chemical_compound
Internal medicine
medicine
Humans
Prospective Studies
Aged
Aged, 80 and over
Creatinine
business.industry
Acute kidney injury
Fasting
Acute Kidney Injury
Middle Aged
medicine.disease
Pulse pressure
Blood pressure
chemistry
Ventricular pressure
Cardiology
Cardiology and Cardiovascular Medicine
business
Subjects
Details
- ISSN :
- 18791913
- Volume :
- 159
- Database :
- OpenAIRE
- Journal :
- The American journal of cardiology
- Accession number :
- edsair.doi.dedup.....0cedcfdcede63020382fa82b9792779d