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Byunghoon Chung, Christopher Seungkyu Lee; Renal function following fluorescein angiography. Invest. Ophthalmol. Vis. Sci. 2014;55(13):258.
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To determine the effect of fluorescein angiography(FAG) on renal function and development of acute kidney injury(AKI).
This retrospective study identified all fluorescein angiographies from 2005 to 2013 at a single facility. Patients with baseline and post-FAG serum creatinine (SCr) level were included. Patients were sorted into low- (<1.5 mg/dL), medium (1.5-2.0 mg/dL), and high-risk (>2.0 mg/dL) subgroups of presumed risk for AKI by using baseline SCr level. Other subgroups were patients with diabetes(DM), diabetic nephropathy(DMN), diabetic retinopathy(DMR), acute renal failure(ARF), chronic kidney disease(CKD), and congestive heart failure(HF). SCr level was compared before and after FAG in each subgroup.
A total 186 patients with baseline and post-FAG SCr level were identified. SCr values before and after FAG were not significantly different in all risk subgroups except high risk group, however post FAG SCr appeared to be significantly lower than pre FAG SCr in the high risk group. (P overall 0.86; DM 0.42; DMN 0.78;DMR 0.40;ARF 0.82;CKD 0.11;HF 0.68;Low risk 0.13;Medium risk 0.83;High risk 0.03) 4 out of 186 patients(2.2%) were noted to develop AKI after FAG. Each 3 patients among these 4 patients had ureteral obstruction, intravenous amphotericin nephrotoxicity, tumor lysis syndrome, and all three patients showed normalized SCr after treatment of underlying causes.
There was no evidence that FAG induces acute renal function deterioration. Patients with diabetes, diabetic retinopathy, diabetic nephropathy, acute renal failure, chronic kidney disease and congestive heart failure showed no significant SCr change before and after FAG. In clinical settings, FAG could be done to high risk patients with careful observation
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