Loss of Kidney Function after Endovascular Treatment of Peripheral Arterial Disease

Sigterman, Tim A.; Bolt, Lars J.J.; Krasznai, A; Snoeijs, Maarten G.; Heijboer, Roel J.J.; Schurink, Geert Willem H.; Bouwman, Lee H.

doi:10.1016/j.avsg.2016.07.100

Cited by 5 publications

(6 citation statements)

References 13 publications

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“…Periprocedural variables related to 1-year GFR decline included percentage increase in 30-day post procedural creatinine concentration (p = 0.025), whereas CIN resolution by discharge (mean, 13.1 days) was protective for renal function at 1-year observation (p = 0.02) [122]. Retrospective observational cohort study by Sigterman et al includes all patients who newly presented to the vascular surgery outpatient clinic with Rutherford class II or III PAD and who were treated with either supervised exercise therapy or endovascular interventions [123]. Changes in eGFR after one year were compared between the two treatment groups.…”

Section: Peripheral Vascular Interventionmentioning

confidence: 99%

“…Changes in eGFR after one year were compared between the two treatment groups. Authors showed that after one year, eGFR was reduced by 8.6 mL/min (95% confidence interval [CI], 7.3-9.9, p < 0.001) in endovascular intervention group (n = 284) and by 1.7 mL/min (95% CI, 0.9-25, p < 0.001) in supervised exercise therapy group (n = 299) [123]. After correction of potential confounders, endovascular interventions were associated with 9.2 mL/min (95% CI, 5.9-12.4, p < 0.001) higher renal decline compared to exercise therapy.…”

Section: Peripheral Vascular Interventionmentioning

confidence: 99%

“…Similar results were found in the propensity score-matched paired analysis. The authors concluded that endovascular procedures for PAD are associated with clinically relevant and long-term loss of kidney function [32,123]. Prasad et al published a meta-analysis of 20 studies that included data on patients undergoing either peripheral angiography or interventions [115].…”

Section: Peripheral Vascular Interventionmentioning

confidence: 99%

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Acute Renal Failure/Acute Kidney Injury (AKI) Associated with Endovascular Procedures

et al. 2020

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AKI is one of the most common yet underdiagnosed postoperative complications that can occur after any type of surgery. Contrast-induced nephropathy (CIN) is still poorly defined and due to a wide range of confounding individual variables, its risk is difficult to determine. CIN mainly affects patients with underlying chronic kidney disease, diabetes, sepsis, heart failure, acute coronary syndrome and cardiogenic shock. Further research is necessary to better understand pathophysiology of contrast-induced AKI and consequent implementation of effective prevention and therapeutic strategies. Although many therapies have been tested to avoid CIN, the only potent preventative strategy involves aggressive fluid administration and reduction of contrast volume. Regardless of surgical technique—open or endovascular—perioperative AKI is associated with significant morbidity, mortality and cost. Endovascular procedures always require administration of a contrast media, which may cause acute tubular necrosis or renal vascular embolization leading to renal ischemia and as a consequence, contribute to increased number of post-operative AKIs.

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Section: Peripheral Vascular Interventionmentioning

confidence: 99%

Section: Peripheral Vascular Interventionmentioning

confidence: 99%

Section: Peripheral Vascular Interventionmentioning

confidence: 99%

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Acute Renal Failure/Acute Kidney Injury (AKI) Associated with Endovascular Procedures

et al. 2020

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“…It was found that the incidence of CI-AKI was higher in the coronary angiography group (16.5%) than contrast (12.5%) group. 54 Similar propensity score matching studies of Medalion et al 55 Sigterman et al 56 and shah et al 57 also showed nephrotoxicity following intra-arterial administration of contrast material during coronary angiography. Based on the pathophysiologic mechanisms and some of the above mentioned studies that reported lower rates of AKI, it is our position that CI-AKI is real and does exist in patients even with prophylactic measures, particularly after coronary angiography than CT enhanced scans.…”

Section: Does Ci-aki Really Exist?mentioning

confidence: 66%

Contrast-Induced Acute Kidney Injury: Evidence in Support of Its Existence and a Review of Its Pathogenesis and Management

Chaudhari¹,

Mahendrakar²,

Baskin³

et al. 2022

IJNRD

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The role of contrast-induced nephropathy (CIN) remains controversial. Many experts contend that CIN does not exist or is extremely rare. The diagnosis was previously made too frequently and inappropriately in the presence of coexisting and confounding comorbidities and risk factors making it difficult to singularly isolate the etiologic role of intravenous contrast media in acute kidney injury (AKI). It is probable that many patients were denied important diagnostic information from radiocontrast studies for fear of CIN. Recently, a new terminology for CIN was introduced, and the term CIN was replaced by two interrelated new terms: one is contrast-associated acute kidney injury (CA-AKI), and the second one is contrast-induced acute kidney injury (CI-AKI). CA-AKI occurs in association with risk factors or comorbidities, therefore, it is a correlative diagnosis. On the other hand, CI-AKI is a subtype of CA-AKI that results directly from iodinated contrast media. In this review, we present evidence from various studies that argue against CI-AKI and also those that suggest its existence but with much lower frequency. We will also provide the current status of the pathophysiology and management of CA-AKI/CI-AKI.

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“…Progressive renal dysfunction is an issue following vascular surgery interventions. 29 Could RIPC ameliorate the initial injury and therefore improve the long-term renal outcomes? If so, it may be a clinically useful intervention.…”

Section: Design Of Future Studiesmentioning

confidence: 99%

Remote Preconditioning and Vascular Surgery

Healy

Walsh

2017

J Cardiovasc Pharmacol Ther

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Remote ischemic preconditioning (RIPC) is a theoretically attractive strategy for organ protection; and phase 2 studies in a variety of settings have yielded promising results. In this article, we review the existing clinical studies on RIPC in vascular surgery. We examine aspects of design that may potentially be optimized in future vascular surgery studies and we highlight some challenges that have emerged since the publication of the Remote Ischaemic Preconditioning for Heart Surgery (RIPHeart) trial and the Effect of Remote Ischaemic Preconditioning on Clinical Outcomes in Patients Undergoing Coronary Artery Bypass Surgery (ERICCA) trial.

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Loss of Kidney Function after Endovascular Treatment of Peripheral Arterial Disease

Cited by 5 publications

References 13 publications

Acute Renal Failure/Acute Kidney Injury (AKI) Associated with Endovascular Procedures

Acute Renal Failure/Acute Kidney Injury (AKI) Associated with Endovascular Procedures

Contrast-Induced Acute Kidney Injury: Evidence in Support of Its Existence and a Review of Its Pathogenesis and Management

Remote Preconditioning and Vascular Surgery

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