Sabeti S, Schillinger M, Mlekusch W, Ahmadi R, Minar E
University of Vienna, Department of Angiology, Vienna General Hospital, Währinger Gürtel 18-20, A-1090 Vienna, Austria.
Eur J Vasc Endovasc Surg. 2002 Aug;24(2):156-60. doi: 10.1053/ejvs.2002.1655.
To investigate the incidence and risk factors for renal function deterioration after renal angiography and angioplasty or stenting.
A retrospective study of 85 consecutive patients undergoing selective renal artery arteriography (n = 53) or renal artery angioplasty % (PTRA) stenting (n = 32) for renal artery stenosis. Multivariate logistic regression analysis was used to determine independent predictors of deterioration of renal function, defined as an increase of serum creatinine by at least one third within 24 h.
Deterioration of renal function occurred in 13 patients (15%), [8/53 (15%) after angiography and 5/32 (16%) after PTRA/stenting]. Only pre-existing renal impairment (se-creatinine > or = 177 mumol/l) (Odds ratio: 40; 95% confidence interval 1.2-72, p = 0.02) and administered dosage of contrast agent (more than 225 ml) (OR 67; 95% CI 11.8-100, p = 0.02) were independently associated with renal function deterioration.
Transient renal dysfunction after renal artery angiography or PTRA/stenting occurs in about 15% of patients, but persistent renal failure is uncommon. Pre-existing renal impairment and amount of contrast agent are independent risk factors. Endovascular treatment of renal artery stenosis is not associated with a higher risk of renal deterioration compared to selective renal angiography.
探讨肾血管造影及血管成形术或支架置入术后肾功能恶化的发生率及危险因素。
对85例因肾动脉狭窄接受选择性肾动脉造影（n = 53）或经皮肾动脉腔内血管成形术（PTRA）/支架置入术（n = 32）的连续患者进行回顾性研究。采用多因素logistic回归分析确定肾功能恶化的独立预测因素，肾功能恶化定义为24小时内血清肌酐至少升高三分之一。
13例患者（15%）出现肾功能恶化，[血管造影术后8/53例（15%），PTRA/支架置入术后5/32例（16%）]。仅既往存在肾功能损害（血清肌酐≥177μmol/L）（比值比：40；95%置信区间1.2 - 72，p = 0.02）和造影剂使用剂量（超过225 ml）（OR 67；95% CI 11.8 - 100，p = 0.02）与肾功能恶化独立相关。
肾动脉造影或PTRA/支架置入术后约15%的患者会出现短暂性肾功能障碍，但持续性肾衰竭并不常见。既往存在的肾功能损害和造影剂用量是独立的危险因素。与选择性肾动脉造影相比，肾动脉狭窄的血管内治疗与肾功能恶化风险升高无关。
