THE ROLE OF CORONARY ANGIOGRAPHY IN THE MANAGEMENT OF CHRONIC KIDNEY DISEASE PATIENTS WITH SUSPECTED CORONARY ARTERY DISEASE

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Dr. Mrs.Kapale R.J., Dr. Aparna Patange, Dr. Mrs. N.V. Kanase

Abstract

Background: Chronic kidney disease (CKD) patients are at increased risk of contrast-induced nephropathy (CIN) when undergoing angiography. Various strategies aim to minimize this risk, but their comparative effectiveness remains unclear.
Objective: This study compares four strategies for minimizing CIN in CKD patients undergoing angiography: pre-procedural hydration, limited contrast volume, low-osmolar/iso-osmolar contrast agents, and N-acetylcysteine supplementation.
Results: Pre-procedural hydration demonstrated the lowest incidence of CIN (10%) and longest-term renal function preservation (90%). Limited contrast volume showed the lowest change in serum creatinine (5%) and highest patient satisfaction (90%). Low-osmolar/iso-osmolar contrast agents exhibited the highest evidence strength (85%) and clinical workflow impact (95%). N-acetylcysteine supplementation had a moderate incidence of CIN (12%) and showed promising long-term renal function preservation (85%).
Conclusion: Each strategy for minimizing CIN in CKD patients undergoing angiography has distinct advantages and limitations. Pre-procedural hydration appears most effective in reducing CIN incidence and preserving long-term renal function, while limited contrast volume ensures minimal changes in serum creatinine and high patient satisfaction. Low-osmolar/iso-osmolar contrast agents offer strong evidence support and minimal workflow disruption. N-acetylcysteine supplementation shows promise in long-term renal function preservation. Clinicians should consider these findings when selecting CIN prevention strategies based on patient-specific factors and institutional resources.

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How to Cite
Dr. Mrs. N.V. Kanase, D. M. R. D. A. P. (2024). THE ROLE OF CORONARY ANGIOGRAPHY IN THE MANAGEMENT OF CHRONIC KIDNEY DISEASE PATIENTS WITH SUSPECTED CORONARY ARTERY DISEASE. Obstetrics and Gynaecology Forum, 34(3s), 421–428. Retrieved from http://obstetricsandgynaecologyforum.com/index.php/ogf/article/view/298
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