Scientific article

Renin-angiotensin system blockade and contrast-induced renal toxicity

Published inJN. Journal of Nephrology, vol. 21, no. 5, p. 681-685
Publication date2008

BACKGROUND: The influence of angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin II receptor blockers (ARBs) on contrast-induced renal toxicity has been poorly studied. Nevertheless, it is a common practice in many centers to stop these drugs before coronarography. Our goal was to study whether renal function was affected in patients taking ACEIs or ARBs and undergoing a coronary angiogram. METHODS: Patients on ACEIs or ARBs (n=17) and those not on ACEIs or ARBs (n=18) admitted for a coronary angiogram underwent glomerular filtration rate (GFR) and effective renal plasma flow (ERPF) assessment either by isotopic clearances (51Cr-EDTA and MAG3) or inulin and paraimmuno-hippurate clearances 24 hours prior to and immediately after coronary angiogram. RESULTS: Median percentage GFR changes induced by the injection of contrast medium during coronary angiogram were -9% (interquartile range -19% to +3%) in the control group and -1% (interquartile range -9% to +39%) in the ACEI/ARB group. Mean ERPF remained stable after coronarography in the control group (median change -8%; interquartile range -18% to +6%) and increased slightly in the ACEI/ARB group (median change +9%; interquartile range -17% to +60%). The median percentage difference in EPRF change was not statistically significant between the 2 groups (p=0.18). CONCLUSIONS: Inhibition of the renin-angiotensin system is not associated with a decline in renal function in patients receiving contrast media, and there is no need to interrupt this treatment prior to coronary angiogram.

  • Angiotensin II Type 1 Receptor Blockers/adverse effects/therapeutic use
  • Angiotensin-Converting Enzyme Inhibitors/adverse effects/therapeutic use
  • Contrast Media/adverse effects
  • Coronary Angiography
  • Female
  • Glomerular Filtration Rate/drug effects
  • Humans
  • Kidney/drug effects
  • Male
  • Middle Aged
  • Radioisotope Renography
  • Renal Blood Flow, Effective/drug effects
Citation (ISO format)
SAUDAN, Patrick et al. Renin-angiotensin system blockade and contrast-induced renal toxicity. In: JN. Journal of Nephrology, 2008, vol. 21, n° 5, p. 681–685.
ISSN of the journal1121-8428

Technical informations

Creation06/10/2009 10:47:00 AM
First validation06/10/2009 10:47:00 AM
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