Abstract: SA-PO086
Contrast-Related Risk of Progressing to ESRD in Patients Undergoing Percutaneous Coronary Intervention: Iohexol vs. Iodixanol
Session Information
- AKI: Epidemiology, Risk Factors, Prevention - II
November 04, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Acute Kidney Injury
- 101 AKI: Epidemiology, Risk Factors, and Prevention
Authors
- Chang, David R., China Medical University Hospital, Taichung, Taiwan
- Lu, Sz Ying, China Medical University Hospital, Taichung, Taiwan
- Lin, Zi-Han, China Medical University Hospital, Taichung, Taiwan
- Kuo, Chin-Chi, China Medical University Hospital, Taichung, Taiwan
- Chiang, Hsiu-Yin, China Medical University Hospital, Taichung, Taiwan
Background
Our study aims to determine the differential risk of accelerated progression to end-stage renal disease (ESRD) associated with the contrast agents Iohexol and Iodixanol in patients undergoing percutaneous coronary intervention (PCI). This research is particularly important for addressing concerns about the use of PCI in individuals with chronic kidney disease (CKD).
Methods
This matched cohort study identified patients undergoing PCI of China Medical University Hospital between 2003 and 2017. For each patient administered with Iohexol, we identified a corresponding patient who was administered Iodixanol, ensuring that they were matched in terms of age, sex, baseline serum creatinine, and the year of the procedure. We employed multivariable Cox proportional hazard models to evaluate the risk of ESRD in the Iohexol group in comparison to the Iodixanol group. Subgroup analyses were further conducted specifically for patients with and without CKD.
Results
Among a total of 5,335 patients who used Iohexol and an equal number of control patients who used Iodixanol, we noted ESRD incidence rates of 3.47% and 3.26%, respectively. In the subcategory of patients with CKD, the incidence rates were 17.4% and 17.3% respectively for the Iohexol and Iodixanol groups. After adjusting for factors such as hypertension, diabetes, heart failure, medication use, electrolyte levels, and hemoglobin, we found that Iodixanol significantly associated with lower risk of ESRD with an adjusted hazard ratio (aHR) of 0.65 (95% CI, 0.47–0.90; p-value: 0.01), compared with the Iohexol group. In the subgroup analysis, the protective effect was only observed among patients with CKD with an adjusted hazard ratio (aHR) of 0.70 (95% CI, 0.49–0.99; p-value: 0.04).
Conclusion
Our study suggests that Iodixanol is significantly associated with a reduced risk of progression to ESRD following PCI compared to Iohexol in real-world practice. Therefore, when considering contrast agents for these procedures, particularly in CKD patients, Iodixanol emerges as a preferable choice to mitigate the risk of ESRD.
Table 2. Hazard ratios for risk of progression to ESRD
Funding
- Government Support – Non-U.S.