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J Vasc Interv Radiol. 2013 May;24(5):726-33. doi: 10.1016/j.jvir.2013.01.496. Epub 2013 Mar 27.

Adrenal venous sampling for primary hyperaldosteronism in patients with concurrent chronic kidney disease.

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1
Department of Radiology, Division of Interventional Radiology, University of Pennsylvania Medical Center, Philadelphia, PA 19104, USA.

Abstract

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.

PMID:
23541280
DOI:
10.1016/j.jvir.2013.01.496
[Indexed for MEDLINE]
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