Renal function after ductus arteriosus transcatheter closure with or without angiography in very preterm infants

• Published in: Acta Paediatrica Vol. 113; no. 5; pp. 955 - 961
• Main Authors: Lembo, Chiara, Méot, Mathilde, Mellul, Kelly, Aryafar, Annahita, Szézépanski, Isabelle, Iacobelli, Silvia, Kermorvant‐Duchemin, Elsa, Bonnet, Damien, Malekzadeh‐Milani, Sophie, Lapillonne, Alexandre
• Format: Journal Article
• Language: English
• Published: Norway Wiley Subscription Services, Inc 01.05.2024; Wiley
• Subjects: acute kidney injury; Angiography; Blood levels; Contrast agents; Contrast media; Contrast Media - adverse effects; contrast‐induced nephropathy; Creatinine; Ductus Arteriosus; Ductus Arteriosus, Patent - diagnostic imaging; Humans; Infant; Infant, Newborn; Infant, Premature; Infant, Premature, Diseases; Infants; Kidney - diagnostic imaging; Life Sciences; Medical imaging; Neonates; Nephropathy; Newborn babies; patent ductus arteriosus preterm infants; Premature babies; Renal function; transcatheter closure of the patent arterial duct; Treatment Outcome; transcatheter closure of the patent arterial duct; contrast‐induced nephropathy; acute kidney injury; patent ductus arteriosus preterm infants
• ISSN: 0803-5253; 1651-2227; 1651-2227
• DOI: 10.1111/apa.17101

Aim Transcatheter closure of the patent ductus arteriosus (TCPDA) is increasingly used in preterm infants as an alternative to surgical ligation. However, clinically ill preterm infants are at risk of contrast nephropathy due to the angiography contrast agents used during the procedure. Methods We performed a single‐centre before‐and‐after comparative study in VLBW infants to compare the kinetics of serum creatinine during the first 4 days after TCPDA with or without angiography. Results 69 patients were included and divided into two groups: TCPDA with (contrast+; n = 37) and without (contrast−, n = 32) use of contrast agent. The median dose [range] of contrast agent was 1.0 mL/kg [0.6–2.4 mL/kg]. The change in serum creatinine level between day 2 to 4 after TCPCA and baseline decreased in the contrast‐ group (−17% [−46%; 18%]), while it increased in the contrast+ group (7% [−24%; 202%] p = 0.002). Comparison of blood urea levels between groups showed similar significant differences. The change in serum creatinine between day 2 to 4 and baseline was significantly correlated with the dose of contrast agent (r2 = 0.682; p < 0.001). Conclusion The use of contrast agents during TCPDA can potentially harm the renal function of very preterm infants. Therefore, we advise minimising or avoiding the use of contrast agents.