Research finds heart procedures safe for kidney patients

CALGARY- 87-year-old Bill Backs suffers from kidney disease, but several years ago he also faced a second health problem: heart disease.

“I had to have bypass surgery,” Bill recalls, “but now I’m pretty much without problems as far as my heart is concerned.”

About 50 per cent of kidney disease patients will also develop heart disease but until now,  heart disease treatment options for these patients have been limited.

“We know that people with kidney disease are at very high risk for heart disease,” explains Dr. Matthew James, a nephrologist with the University of Calgary’s Libin Cardiovascular Institute. “We also know that people with kidney disease are much less likely to receive procedures like angiogram or angioplasty because of the fear their kidney disease could get worse”

An angiogram helps cardiologists discover blockages in arteries.  Left untreated, these blockages can cause a heart attack.  The problem for kidney patients is that during an angiogram the patient is injected with dye that eventually has to pass through the kidney.

“A number of studies have shown that after an angiogram and exposure to those dyes, kidney functions can suddently drop,” says James.

Cardiologist, Dr. Merril Knudtson says when it came to kidney patients, some doctors were reluctant to perform these potentially life saving heart procedures. So, together with James,  Knudston decided to investigate.

“Whenever a procedure is done you always try to weigh what the risks of doing the procedure are against the benefit,” Knudston explains.

The research team used two province-wide medical record databases (APPROACH and AKDN) to do a large observational study of more than 10,000 individuals.  They found the benefits to the heart procedures far outweighed  any potential kidney risk.

“There were some risks to people with kidney disease after these angiograms,” says James. “They are however quite small and some of the most concerning events like dialysis of kidney failure actually aren’t significantly increased.”

The team’s research has been published in the July 2013 edition of the British Medical Journal.