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Contrast nephropathy post cardiac resynchronization therapy: An under‐recognized complication with important morbidity
Author(s) -
Cowburn Peter J.,
Patel Harshna,
Pipes Rebecca R.,
Parker John D.
Publication year - 2005
Publication title -
european journal of heart failure
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 5.149
H-Index - 133
eISSN - 1879-0844
pISSN - 1388-9842
DOI - 10.1016/j.ejheart.2004.10.023
Subject(s) - medicine , nephropathy , contrast induced nephropathy , complication , heart failure , creatinine , renal function , surgery , cardiology , diabetes mellitus , endocrinology
Objectives The aim of the study was to define the incidence of contrast nephropathy in patients undergoing cardiac resynchronization therapy (CRT). Background CRT is a promising new treatment for advanced heart failure. It is a technically demanding procedure with a recognized failure/complication rate. Contrast nephropathy is a well‐recognized complication of coronary angiography/intervention, but has not been described following CRT. Methods We performed a retrospective chart review of patients who had undergone CRT at Mount Sinai Hospital, a tertiary referral center for heart failure management, to define the incidence of contrast nephropathy in patients undergoing CRT. Contrast nephropathy was defined as the occurrence of a 25% or greater increase in serum creatinine within 48 h after contrast administration. Results Sixty‐eight patients underwent a total of seventy‐three procedures between October 1st 2000 and December 31st 2003. Ten patients (14%) developed contrast nephropathy. Three of these patients (4%) required hemofiltration and one died. Patients with creatinine ≥200 μmol/l (2.26mg/dl) were more likely to develop contrast nephropathy than those with creatinine <200 μmol/l (6/14 patients [43%] v 4/59 patients [7%], p <0.01). The mean length of hospital stay post‐procedure in patients developing contrast nephropathy was 19±18 (SD) days versus 4±5 days for those patients with stable renal function ( p <0.01). Conclusions Contrast nephropathy is a frequent, but under‐recognized complication of CRT with important morbidity/mortality. The extended hospital stay associated with contrast nephropathy has important clinical and health care implications. Patients and physicians need to be aware of this potential risk.