Please use this identifier to cite or link to this item: https://ahro.austin.org.au/austinjspui/handle/1/12373
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 Cardiology, Austin Hospital, Melbourne, VIC 3084, Australia
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 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
URI: http://ahro.austin.org.au/austinjspui/handle/1/12373
DOI: 10.1155/2014/506479
URL: https://pubmed.ncbi.nlm.nih.gov/25180184
Type: Journal Article
Appears in Collections:Journal articles

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