© 2005 European Society of Cardiology
Contrast nephropathy post cardiac resynchronization therapy: An under-recognized complication with important morbidity
Mount Sinai Hospital 600 University Avenue, Suite 1609, Toronto, Ontario, Canada, M5G 1X5
* Corresponding author. Tel.: +1 416 586 4794; fax: +1 416 586 8413. E-mial address: jdp{at}ca.inter.net
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Abstract |
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Objectives: The aim of the study was to define the incidence of contrast nephropathy in patients undergoing cardiac resynchronization therapy (CRT).
Background: CRT is a promising new treatment for advanced heart failure. It is a technically demanding procedure with a recognized failure/complication rate. Contrast nephropathy is a well-recognized complication of coronary angiography/intervention, but has not been described following CRT.
Methods: We performed a retrospective chart review of patients who had undergone CRT at Mount Sinai Hospital, a tertiary referral center for heart failure management, to define the incidence of contrast nephropathy in patients undergoing CRT. Contrast nephropathy was defined as the occurrence of a 25% or greater increase in serum creatinine within 48 h after contrast administration.
Results: Sixty-eight patients underwent a total of seventy-three procedures between October 1st 2000 and December 31st 2003. Ten patients (14%) developed contrast nephropathy. Three of these patients (4%) required hemofiltration and one died. Patients with creatinine 
200 µmol/l (2.26mg/dl) were more likely to develop contrast nephropathy than those with creatinine <200 µmol/l (6/14 patients [43%] v 4/59 patients [7%], p<0.01). The mean length of hospital stay post-procedure in patients developing contrast nephropathy was 19±18 (SD) days versus 4±5 days for those patients with stable renal function (p<0.01).
Conclusions: Contrast nephropathy is a frequent, but under-recognized complication of CRT with important morbidity/mortality. The extended hospital stay associated with contrast nephropathy has important clinical and health care implications. Patients and physicians need to be aware of this potential risk.
Key Words: Resynchronization • Nephropathy • Heart failure
Received July 16, 2004; Revised August 29, 2004; Accepted October 15, 2004
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