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Coronary Angiography and Acute Renal Failure in Diabetic Azotemic Nephropathy

L. A. WEINRAUCH, M.D.; R. W. HEALY, M.D.; O. S. LELAND Jr., M.D.; H. H. GOLDSTEIN, M.D.; S. D. KASSISSIEH, M.D.; J. A. LIBERTINO, M.D.; F. J. TAKACS, M.D., F.A.C.P.; and J. A. D'ELIA, M.D., F.A.C.P.
[+] Article and Author Information

This work was presented in part at the Regional Meeting of the American College of Physicians, Hanover, NH, October 1976 and at the 9th Annual Meeting of the American Society of Nephrology, Washington, D.C., November 1976.

▸Requests for reprints should be addressed to L. A. Weinrauch, M.D.; Cardiology Section, Department of Medicine, New England Deaconess Hospital, 185 Pilgrim Road; Boston, MA 02215.


Boston, Massachusetts


Ann Intern Med. 1977;86(1):56-59. doi:10.7326/0003-4819-86-1-56
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Thirteen juvenile-onset diabetics with azotemic diabetic nephropathy (mean serum creatinine level, 6.8 mg/dl) being evaluated for renal transplantation underwent cardiac catheterization with angiography. All were followed for development of acute renal failure. Twelve (92%) developed some evidence of acute renal failure. Two required potassium exchange resin therapy. Six required dialysis acutely. There were no deaths. All patients who received greater than 65 ml/m2 of iodinated contrast developed acute renal failure. No patient with a hemoglobin value greater than 9.9 g/dl required dialysis or potassium exchange resin. The single patient without acute renal failure received less than 50 ml/m2 of iodinated contrast and had the highest hemoglobin value (12.0 g/dl). No cardiac or angiographic variables were predictive of acute renal failure. In this group at high risk for acute renal failure, radiographic contrast procedures should only be done if the information to be obtained is weighed against the potential for injury.

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