What are the risks of revascularization in patients with renal disease?
Patients with chronic kidney disease (CKD) are at greater risk for developing coronary artery disease, for its progression, and for poor outcomes after interventions for acute myocardial infarction (AMI). The mortality rate for patients on hemodialysis is 20% per year, and approximately 50% of deaths among these patients are due to a cardiovascular cause. To avoid worsening underlying kidney disease, physicians should consider creatinine clearance in pharmacotherapy and should apply risk scores for predicting the likelihood of contrast-induced nephropathy in conjunction with the use of renal protective strategies such as isosmolar contrast agents during angiography.