Safety of Low Volume Iodinated Contrast Administration for Arteriovenous Fistula Intervention in Chronic Kidney Disease Stage 4 or 5 Utilizing a Bicarbonate Prophylaxis Strategy
Article first published online: 22 DEC 2010
© 2010 Wiley Periodicals, Inc.
Seminars in Dialysis
Volume 23, Issue 6, pages 638–642, November/December 2010
How to Cite
Eisenhart, E., Benson, S., Lacombe, P., Himmelfarb, J., Zimmerman, R., Schimelman, B. and Parker, M. G. (2010), Safety of Low Volume Iodinated Contrast Administration for Arteriovenous Fistula Intervention in Chronic Kidney Disease Stage 4 or 5 Utilizing a Bicarbonate Prophylaxis Strategy. Seminars in Dialysis, 23: 638–642. doi: 10.1111/j.1525-139X.2010.00800.x
- Issue published online: 22 DEC 2010
- Article first published online: 22 DEC 2010
Efforts to increase the number of functioning arteriovenous fistulas in chronic kidney disease (CKD) stages 4 and 5 have been impacted by concerns about the risk for contrast-induced nephropathy during diagnostic and interventional procedures for poorly developed fistulas. We conducted a prospective observational study of low volume iodinated contrast administration for fistulography and angioplasty in a CKD stage 4 and stage 5 population pretreated with a sodium bicarbonate protocol. Acute kidney injury was assessed by change in serum creatinine and urinary neutrophil-gelatinase associated lipocalcin (NGAL). Only 1/18 patients (5.5%) developed acute kidney injury as defined by change in serum creatinine 48 hours after contrast exposure. No patients demonstrated significant change in urinary NGAL at 3 or 48 hours after procedure, nor did any require acute initiation of dialysis. Fistulography alone, or with angioplasty, utilizing a low volume of iodinated contrast and sodium bicarbonate solution for prophylaxis, appears to be safe in the CKD stages 4 and 5 population.