Coronary Angiography and Contrast-Induced Nephropathy

Contrast‐induced acute kidney injury following PCI

“…The available data on the use of ACE-I with associated risks of CI-AKI are sparse and conflicting. Some reports have proposed the use of ACE-I to protect the kidneys from the effects of CI-AKI [79,81], while other reports have implicated ACE-I to be nephrotoxic and exacerbate renal failure in patients with CI-AKI, especially for patients with pre-existing renal impairment [82,83]. They suggest omitting the drug for 24 h prior to a coronary angiogram [84].…”

Preventing Contrast-induced Renal Failure: A Guide

“…27 In patients with CKD, Moore et al and Barrett et al described an increase from 4 to 20 % in the incidence of CI-AKI as the baseline serum creatinine level rose from 1.2 to 2.9 mg/dl. 28 In addition, a larger decrement in eGFR 2 years following the procedure has been observed in patients with CKD who experienced transient CI-AKI after coronary angiography (eGFR at 2 years, -20 ± 11 ml/min 1.73 m 2 versus -6 ± 16 ml/min/1.73 m 2 ; p=0.02). 13 Since accurate determination of kidney function is so critical in CKD patients undergoing CM exposure, direct measurement of the creatinine clearance (CrC) or estimation of GFR with the MDRD equation is preferable to serum creatinine in order to assess renal function.…”