Contrast-Induced Nephropathy Is Less Common in Patients with Good Coronary Collateral CirculationAvci E.a · Yildirim T.b · Kadi H.a
aCardiology Department, Balikesir University Faculty of Medicine, and bCardiology Clinic, Balikesir State Hospital, Balikesir, Turkey
Do you have an account?
- Rent for 48h to view
- Buy Cloud Access for unlimited viewing via different devices
- Synchronizing in the ReadCube Cloud
- Printing and saving restrictions apply
Rental: USD 8.50
Cloud: USD 20.00
Article / Publication Details
Background/Aims: Contrast-induced nephropathy (CIN) is a typically reversible type of acute renal failure that develops after exposure to contrast agents; underlying endothelial dysfunction is thought to be an important risk factor for CIN. Although the mechanism of coronary collateral circulation (CCC) is not fully understood, a pivotal role of the endothelium has been reported in many studies. The aim of this study was to investigate whether there is a relationship between CCC and CIN. Methods: Patients with at least one occluded major coronary artery and blood creatinine analyses performed before and on the second day after angiography were included in the study. CIN was defined as a 25% or greater elevation of creatinine on the second day after exposure to the contrast agent. Collateral grading was performed according to the Rentrop classification. Patients were grouped according to whether they developed CIN or not, i.e., CIN(-) and CIN(+) group. Results: A total of 214 patients who met the inclusion criteria were included in the study. CIN was diagnosed in 43 patients (20.1%) in the study population. Good CCC was identified in 112 patients (65.5%) in the CIN(-) group, whereas it was identified in 13 patients (30.2%) in the CIN(+) group. In the CIN(-) group, good CCC was significantly more frequent (p < 0.001). Furthermore, collateral circulation was an independent predictor of CIN. Conclusion: Good collateral circulation was associated with a lower frequency of CIN, and poor collateral circulation was an independent predictor of CIN.
© 2017 S. Karger AG, Basel
- Rihal CS, Textor SC, Grill DE, Berger PB, Ting HH, Best PJ, Singh M, Bell MR, Barsness GW, Mathew V, Garratt KN, Holmes DR Jr: Incidence and prognostic importance of acute renal failure after percutaneous intervention. Circulation 2002;105:2259-2264.
- McCullough PA, Wolyn R, Rocher LL, Levin RN, O'Neill WW: Acute renal failure after coronary intervention: incidence, risk factors, and relationship to mortality. Am J Med 1997;103:368-375.
- Iakovou I, Dangas G, Mehran R, Lansky AJ, Ashby DT, Fahy M, Mintz GS, Kent KM, Pichard AD, Satler LF, Stone GW, Leon MB: Impact of gender on the incidence and outcome of contrast-induced nephropathy after percutaneous coronary intervention. J Invasive Cardiol 2003;15:18-22.
- Manske CL, Sprafka JM, Strony JT, Wang Y: Contrast nephropathy in azotemic diabetic patients undergoing coronary angiography. Am J Med 1990;89:615-620.
- Budano C, Levis M, D'Amico M, Usmiani T, Fava A, Sbarra P, Burdese M, Segoloni GP, Colombo A, Marra S: Impact of contrast-induced acute kidney injury definition on clinical outcomes. Am Heart J 2011;161:963-971.
- Cho JY, Jeong MH, Hwan Park S, Kim IS, Park KH, Sim DS, Yoon NS, Yoon HJ, Park HW, Hong YJ, Kim JH, Ahn Y, Cho JG, Park JC, Kang JC: Effect of contrast-induced nephropathy on cardiac outcomes after use of nonionic isosmolar contrast media during coronary procedure. J Cardiol 2010;56:300-306.
- Calver A, Collier J, Vallance P: Inhibition and stimulation of nitric oxide synthesis in the human forearm arterial bed of patients with insulin dependent diabetes. J Clin Invest 1992;90:2548-2554.
- Panza JA, Quyyumi AA, Brush JE, Epstein SE: Abnormal endothelium dependent relaxation in patients with essential hypertension. N Engl J Med 1990;323:22-27.
- Ludmer PL, Selwyn AP, Shook TL, Wayne RR, Mudge GH, Alexander RW, Ganz P: Paradoxical vasoconstriction induced by acetylcholine in atherosclerotic coronary arteries. N Engl J Med 1986;315:1046-1051.
- Kubo SH, Rector TS, Bank AJ, Williams RE, Heifetz SM: Endothelium-dependent vasodilatation is attenuated in patients with heart failure. Circulation 1991;84:1589-1596.
- Weisberg LS, Kurnik PB, Kurnik RC: Radiocontrast-induced nephropathy in humans: role of renal vasoconstriction. Kidney Int 1992;41:1408-1415.
- Levin DC: Pathways and functional significance of the coronary collateral circulation. Circulation 1974;50:831-837.
- Ziche M, Morbidelli L, Masini E, Amerini S, Granger HJ, Maggi CA, Geppetti P, Ledda F: Nitric oxide mediates angiogenesis in vivo and endothelial cell growth and migration in vitro promoted by substance P. J Clin Invest 1994;94:2036-2044.
- Guzman RJ, Abe K, Zarins CK: Flow-induced arterial enlargement is inhibited by suppression of nitric oxide synthase activity in vivo. Surgery 1997;22:273-279.
- Schneeweis S, Grafe M, Bungenstock A, Spencer Hansch C, Fleck E, Goetze S: Chronic CRP-exposure inhibits VEGF-induced endothelial cell migration. J Atheroscler Thromb 2010;17:203-212.
- Rentrop KP, Cohen M, Blanke H, Philips RA: Changes in collateral channel filling immediately after controlled coronary artery occlusion by an angioplasty balloon in human subjects. J Am Coll Cardiol 1985;5:587-592.
- Piek JJ, van Liebergen RA, Koch KT, Peters RJG, David GK: Clinical, angiographic and hemodynamic predictors of recruitable collateral flow assessed during balloon angioplasty coronary occlusion. J Am Coll Cardiol 1997;29:275-282.
- Aspelin P, Aubry P, Fransson SG, Strasser R, Willenbrock R, Berg KJ; Nephrotoxicity in High-Risk Patients Study of Iso-Osmolar and Low-Osmolar Non-Ionic Contrast Media Study Investigators: Nephrotoxic effects in high-risk patients undergoing angiography. N Engl J Med 2003;348:491-499.
- Morcos SK, Thomsen HS, Webb JA: Contrast-media-induced nephrotoxicity: a consensus report. Contrast Media Safety Committee, European Society of Urogenital Radiology (ESUR). Eur Radiol 1999;9:1602-1613.
- McCullough PA, Sandberg KR: Epidemiology of contrast-induced nephropathy. Rev Cardiovasc Med 2003;4(suppl 5):S3-S9.
- Kay J, Chow WH, Chan TM, Lo SK, Kwok OH, Yip A, Fan K, Lee CH, Lam WF: Acetylcysteine for prevention of acute deterioration of renal function following elective coronary angiography and intervention: a randomized controlled trial. JAMA 2003;289:553-558.
- Shyu KG, Cheng JJ, Kuan P: Acetylcysteine protects against acute renal damage in patients with abnormal renal function undergoing a coronary procedure. J Am Coll Cardiol 2002;40:1383-1388.
- Marenzi G, Lauri G, Assanelli E, Campodonico J, De Metrio M, Marana I, Grazi M, Veglia F, Bartorelli AL: Contrast-induced nephropathy in patients undergoing primary angioplasty for acute myocardial infarction. J Am Coll Cardiol 2004;44:1780-1785.
Baroldi G, Scomazzoni G: Coronary circulation in the normal and the pathological heart. Circ Res 1956;4:223-229.
- Pohl T, Seiler C, Billinger M, Herren E, Wustmann K, Mehta H, Windecker S, Eberli FR, Meier B: Frequency distribution of collateral flow and factors influencing collateral channel development. Functional collateral channel measurement in 450 patients with coronary artery disease. J Am Coll Cardiol 2001;38:1872-1878.
- Özbek K, Ceyhan K, Koç F, Söğüt E, Altunkaş F, Karayakalı M, Çelik A, Kadı H, Köseoğlu RD, Önalan O: The protective effect of single dose tadalafil in contrast-induced nephropathy: an experimental study. Anatol J Cardiol 2015;15:306-310.
- Ramponi S, Grotti A, Morisetti A, Lorusso SV: Effects of iodinated contrast media on endothelium: an in vitro study. Toxicol In Vitro 2007;21:191-196.
- Heinrich MC, Kuhlmann MK, Grgic A, Heckmann M, Kramann B, Uder M: Cytotoxic effects of ionic high-osmolar, nonionic monomeric, and nonionic iso-osmolar dimeric iodinated contrast media on renal tubular cells in vitro. Radiology 2005;235:843-849.
- Fernandez-Rodriguez S, Edwards DH, Newton B, Griffith TM: Attenuated store-operated Ca2+ entry underpins the dual inhibition of nitric oxide and EDHF-type relaxations by iodinated contrast media. Cardiovasc Res 2009;84:470-478.
- Weisberg LS, Kurnik PB, Kurnik BRC: Risk of radiocontrast nephropathy in patients with and without diabetes mellitus. Kidney Int 1994;45:259-265.
Article / Publication Details
Copyright / Drug Dosage / DisclaimerCopyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.