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Review
. 2022 Aug 26;1(6):100445.
doi: 10.1016/j.jscai.2022.100445. eCollection 2022 Nov-Dec.

Management of Patients With Kidney Disease in Need of Cardiovascular Catheterization: A Scientific Workshop Cosponsored by the National Kidney Foundation and the Society for Cardiovascular Angiography and Interventions

Anand Prasad  1 , Paul M Palevsky  2 , Shweta Bansal  3 , Glenn M Chertow  4 , James Kaufman  5   6 , Kianoush Kashani  7 , Esther S H Kim  8 , Lakshmi Sridharan  9 , Amit P Amin  10 , Sripal Bangalore  11 , Carlo Briguori  12 , David M Charytan  5 , Marvin Eng  13 , Hani Jneid  14 , Jeremiah R Brown  15 , Roxana Mehran  16 , Mark J Sarnak  17 , Richard Solomon  18 , Charuhas V Thakar  19 , Kevin Fowler  20 , Steven Weisbord  2
Affiliations
Review

Management of Patients With Kidney Disease in Need of Cardiovascular Catheterization: A Scientific Workshop Cosponsored by the National Kidney Foundation and the Society for Cardiovascular Angiography and Interventions

Anand Prasad et al. J Soc Cardiovasc Angiogr Interv. .

Abstract

Patients with chronic kidney disease (CKD) are at an increased risk of developing cardiovascular disease (CVD), whereas those with established CVD are at risk of incident or progressive CKD. Compared with individuals with normal or near normal kidney function, there are fewer data to guide the management of patients with CVD and CKD. As a joint effort between the National Kidney Foundation and the Society for Cardiovascular Angiography and Interventions, a workshop and subsequent review of the published literature was held. The present document summarizes the best practice recommendations of the working group and highlights areas for further investigation.

Keywords: acute kidney injury; cardiovascular procedures; chronic kidney disease.

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Figures

None
Graphical abstract
Figure 1
Figure 1
Theoretical construct of the renal functional reserve and kidney attacks. Small renal insults may remain subclinical if the renal functional reserve (RFR) is preserved. In the case of a true AKI event (kidney attack), there will be a transient reduction in GFR. In both cases, even if GFR returns to normal, recovery of renal function may be complete or partial. In case of partial recovery and reduced RFR, the kidney may be more susceptible to further insults and develop clinically evident AKI even in the presence of mild exposure. A progressive defective repair will then progress toward CKD. AKI, acute kidney injury; CKD, chronic kidney disease; GFR, glomerular filtration rate; RFR, renal functional reserve. Reproduced with revision from Sharma et al. Copyright © 2014 Karger Publishers, Basel, Switzerland.
Figure 2
Figure 2
National Kidney Foundation and the Society for Cardiovascular Angiography and Interventions Workshop Expert Opinion Recommendations for Catheterization Procedures and Acute Kidney Injury Risk Prevention. AKI, acute kidney injury; PCI, percutaneous coronary intervention; TAVR, transcatheter aortic valve replacement.
Central Illustration
Central Illustration
Recommended approach for management of patients with CKD undergoing invasive cardiovascular procedures. AKI, acute kidney injury; CKD, chronic kidney disease; CV, cardiovascular; eGFR, estimated glomerular filtration rate; IV, intravenous; LVEDP, left ventricular end-diastolic pressure.
Figure 3
Figure 3
Recommendations for revascularization in patients with CKD from the 2021 ACC/AHA/SCAI Guideline for Coronary Artery Revascularization. AKI, acute kidney injury; CAD, coronary artery disease; CKD, chronic kidney disease; EO, expert opinion; LD, limited data; NR, nonrandomized; NSTE-ACS, non -ST-elevation acute coronary syndrome; R, randomized; STEMI, ST-segment elevation myocardial infarction.
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