Journal of vascular and interventional radiology : JVIR · 2013
Adrenal venous sampling for primary hyperaldosteronism in patients with concurrent chronic kidney disease.
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Burshteyn Mark, Cohen Debbie L, Fraker Douglas L, Trerotola Scott O
Аннотация
PURPOSE: To assess the risk of developing contrast-induced nephropathy (CIN) and to evaluate the technical success of adrenal venous sampling (AVS) in patients with chronic kidney disease (CKD).
MATERIALS AND METHODS: AVS was performed in 25 patients with primary hyperaldosteronism and concurrent CKD to distinguish between unilateral and bilateral adrenal disease. One of the 25 patients underwent repeat AVS, for a total of 26 samplings. All patients received a hydration protocol before and after the procedure. Acute kidney injury (AKI) (increase in creatinine of 0.5 mg/dL or>25% above baseline) and diagnostic yield were determined.
RESULTS: CKD was stage III in 20 patients (80%), stage IV in 4 patients (16%), and stage V in 1 patient (4%). Median contrast volume was 25 mL (range, 10-250 mL). Of 26 studies, 25 (96%) were diagnostic; the one nondiagnostic AVS was repeated with success. Despite their elevated risks, only 2 of 25 patients (8%) developed AKI, and neither patient required treatment.
CONCLUSIONS: AVS can be performed safely with a high degree of technical success and low risk of CIN in patients with primary hyperaldosteronism and concurrent advanced CKD.
MATERIALS AND METHODS: AVS was performed in 25 patients with primary hyperaldosteronism and concurrent CKD to distinguish between unilateral and bilateral adrenal disease. One of the 25 patients underwent repeat AVS, for a total of 26 samplings. All patients received a hydration protocol before and after the procedure. Acute kidney injury (AKI) (increase in creatinine of 0.5 mg/dL or>25% above baseline) and diagnostic yield were determined.
RESULTS: CKD was stage III in 20 patients (80%), stage IV in 4 patients (16%), and stage V in 1 patient (4%). Median contrast volume was 25 mL (range, 10-250 mL). Of 26 studies, 25 (96%) were diagnostic; the one nondiagnostic AVS was repeated with success. Despite their elevated risks, only 2 of 25 patients (8%) developed AKI, and neither patient required treatment.
CONCLUSIONS: AVS can be performed safely with a high degree of technical success and low risk of CIN in patients with primary hyperaldosteronism and concurrent advanced CKD.