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Title: Extended renal outcomes with use of iodixanol versus iohexol after coronary angiography.
Austin Authors: Chua, Horng-Ruey;Horrigan, Mark C G;Mcintosh, Elizabeth;Bellomo, Rinaldo 
Affiliation: Department of Intensive Care, Austin Hospital, Melbourne, VIC 3084, Australia ; Australian and New Zealand Intensive Care Research Committee (ANZIC-RC), School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3181, Australia
Department of Cardiology, Austin Hospital, Melbourne, VIC 3084, Australia
Department of Intensive Care, Austin Hospital, Melbourne, VIC 3084, Australia ; Division of Nephrology, University Medicine Cluster, National University Hospital, National University Health System, Singapore 119228.
Issue Date: 7-Aug-2014
Publication information: Biomed Research International 2014; 2014(): 506479
Abstract: The impact of isoosmolar versus low-osmolar contrast media (CM) administration on contrast-induced acute kidney injury (CI-AKI) and extended renal dysfunction (ERD) is unclear. We retrospectively examined incidences of CI-AKI and ERD in patients who received iodixanol (isoosmolar) versus iohexol (low-osmolar) during angiography for cardiac indications. Of 713 patients, 560 (cohort A), 190 (cohort B), and 172 (cohort C) had serum creatinine monitored at 3 days, 30 days, and 6 months after angiography, respectively. 18% of cohort A developed CI-AKI, which was more common with iodixanol than iohexol (22% versus 13%, P = 0.006). However, patients given iodixanol were older with lower baseline estimated glomerular filtration rates (eGFR). On multivariate analysis, independent associations with higher CI-AKI risk include age >65 years, female gender, cardiac failure, ST-elevation myocardial infarction, intra-aortic balloon pump, and critical illness, but not CM type, higher CM load, or eGFR < 45 mL/min/1.73 m(2). 32% of cohort B and 34% of cohort C had ERD at 30 days and 6 months, while 44% and 41% of subcohorts had ERD at 90 days and 1 year, respectively. CI-AKI, but not CM type, was associated with medium- and longer-term ERD, with 3-fold higher risk. Advanced age, emergent cardiac conditions, and critical illness are stronger predictors of CI-AKI, compared with CM-related factors. CI-AKI predicts longer-term ERD.
Gov't Doc #: 25180184
DOI: 10.1155/2014/506479
Journal: BioMed research international
Type: Journal Article
Appears in Collections:Journal articles

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