Contrast-induced acute kidney injury following PCI

Authors


Correspondence to: Dr Derek J. Hausenloy, The Hatter Cardiovascular Institute, University College London, 67 Chenies Mews, London WC1E 6HX, UK. Tel.: +44 20 3447 9894; fax: +44 20 3447 9505; e-mail: d.hausenloy@ucl.ac.uk

Abstract

Background

Coronary revascularization using percutaneous coronary intervention (PCI) is one of the major treatments for patients with stable coronary artery disease, with approximately 1.5 million patients undergoing PCI in the United States and Europe every year. An important neglected complication of PCI is contrast-induced acute kidney injury (CI-AKI).

Design

In this article, we review the definition, pathogenesis and management of CI-AKI and highlight potential therapeutic options for preventing CI-AKI in post-PCI patients.

Results

CI-AKI is an important but underdiagnosed complication of PCI that is associated with increased in-hospital morbidity and mortality. Patients with pre-existing renal impairment and diabetes are particularly susceptible to this complication post-PCI. Optimization of the patients' circulating volume remains the mainstay for preventing CI-AKI, although the best strategy for achieving this is still controversial.

Conclusion

Following PCI, CI-AKI is an overlooked complication which is associated with significant morbidity and mortality. In this article, we review the pathophysiology of CI-AKI in patients undergoing PCI and discuss the potential therapeutic options for preventing it.

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