The impact of coronary angiography on renal transplant function

Lees, J.S. , Findlay, M.D., Mark, P.B. and Geddes, C.C. (2019) The impact of coronary angiography on renal transplant function. QJM: An International Journal of Medicine, 112(1), pp. 23-27. (doi:10.1093/qjmed/hcy216) (PMID:30295913)

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Abstract

Introduction: There may be reluctance to perform coronary angiography in kidney transplant patients due to perceived risk of iodinated contrast, despite an increased risk of cardiovascular disease compared with the general population. Aim: We sought to determine if renal transplant function was adversely affected within 7, 30 and 180 days of coronary angiography. Design and methods: Renal transplant recipients undergoing coronary angiography in a single centre (01/2006–02/2018) were identified retrospectively. Baseline and highest SCr within 7, 30 and 180 days of coronary angiography were extracted from the electronic patient record. Rise in creatinine >26 micromol/l was considered significant [equivalent to Acute Kidney Injury (AKI) Network criteria stage 1 AKI] and case note review performed to determine circumstance of renal decline. Results: There were 127 coronary angiographies conducted in 90 patients: 67.7% were male and mean age was 58.0 (±10.1) years. There was AKI within 7 days in 18.9% cases, but SCr returned to baseline within 7 days or there was an alternative explanation for AKI in 83.3% of these. In the remaining four cases, there was progressive decline in renal transplant function. In the absence of critical illness, no patient required dialysis or extended hospital stay for contrast-associated AKI. Conclusions: In this cohort of renal transplant recipients undergoing coronary angiography, AKI occurred in a minority of cases, and in more than 95% of such cases this effect was transient, with progressive renal decline a rare and predictable event. Renal transplant should not be regarded as a contraindication to coronary angiography.

Item Type:Articles
Additional Information:This work was supported by a Kidney Research UK Training Fellowship to JSL [grant number TF_013_20161125].
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Mark, Dr Patrick and Findlay, Dr Mark and Lees, Jennifer and Geddes, Dr Colin
Authors: Lees, J.S., Findlay, M.D., Mark, P.B., and Geddes, C.C.
College/School:College of Medical Veterinary and Life Sciences > Institute of Cardiovascular and Medical Sciences
Journal Name:QJM: An International Journal of Medicine
Publisher:Oxford University Press
ISSN:1460-2725
ISSN (Online):1460-2393
Published Online:08 October 2018
Copyright Holders:Copyright © 2018 The Authors
First Published:First published in QJM: An International Journal of Medicine 112(1): 23-27
Publisher Policy:Reproduced in accordance with the publisher copyright policy

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Project CodeAward NoProject NamePrincipal InvestigatorFunder's NameFunder RefLead Dept
3009230Vitamin K in Transplanted Kidney Organ Recipients: Investigating vEssel Stiffness (ViKTORIES)Jennifer LeesKidney Research UK (KIDNEYRE)TF_013_20161125CAMS - Cardiovascular Science