Incidence of persistent renal dysfunction and long-term survival after coronary computed tomography angiography

Hamza Sunman, Mustafa Arıcı, Serkan Asil, Uğur Canpolat, Hikmet Yorgun, Cem Çöteli, Metin Okşul, Yusuf Ziya Şener, Ulvi Yalçın, Gamze Türk, Tuncay Hazırolan, Kudret Aytemir

Abstract

Background: Renal impairment following contrast exposure can sometimes become permanent, and data on the long- term impact of coronary computed tomography angiography (CTA) on renal dysfunction are limited. We aimed to examine the incidence and long-term outcome of persistent renal dysfunction after coronary CTA.
Methods: We identified 3500 patients with creatinine levels measured before and six months after coronary CTA. A total of 2054 patients were included in the final analysis for contrast-induced nephropathy (CIN) diagnosis, defined as a serum creatinine increase of 0.5 mg/dl or a relative increase of 25% from baseline. Persistent renal dysfunction was defined as an absolute increase of 0.5 mg/dl or a relative increase of 25% in creatinine levels after at least six months of follow-up.
Results: The incidence of CIN was 1.0% and 40 (1.9%) patients had persistent renal dysfunction at median 2.5-year follow-up. Mortality rate was 2.0% (41 patients) and four patients (0.2%) required permanent dialysis during the same period. In multivariate regression analysis; age (odds ratio [OR]: 1.050, p = 0.027), diabetes (OR: 2.769, p = 0.004), baseline renal function (OR: 0.967, p = 0.003), and occurrence of CIN (OR: 7.760, p = 0.002) were identified as independent predictors of persistent renal dysfunction. Furthermore, occurrence of CIN and persistent renal dysfunction were found as independent predictors of long-term mortality.
Conclusion: During follow-up after coronary CTA, the incidence of persistent renal dysfunction was 1.9%, and the occurrence of CIN was the most important risk factor. In addition, both CIN and persistent renal dysfunction were associated with long-term mortality.