Adrenal Venous Sampling for Primary Hyperaldosteronism in Patients with Concurrent Chronic Kidney Disease

作者：Burshteyn Mark; Cohen Debbie L; Fraker Douglas L; Trerotola Scott O^*

来源：Journal of Vascular and Interventional Radiology, 2013, 24(5): 726-733.

DOI：10.1016/j.jvir.2013.01.496

Purpose: To assess the risk of developing contrast-induced nephropathy (ON) 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 gage 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 ON in patients with primary hyperaldosteronism and concurrent advanced CKD.

• 出版日期2013-5