Renal risks of cardiac catheterization in the elderly

Age-related changes in renal structure and function and an increased prevalence of comorbid illnesses predispose the elderly patient to increase risk of contrast-induced nephropathy following cardiac catheterization and other procedures. This article briefly reviews the effects of aging on the kidney, then summarizes current literature on the risks of nephrotoxicity following cardiac catheterization in elderly patients. Finally, a series of therapeutic guidelines are proposed which should serve to minimize the risk of contrast nephropathy in elderly patients requiring cardiac catheterization. Based on available evidence, it is concluded that the risk of serious deterioration in renal function following contrast exposure is acceptably low and should not be considered a strong contraindication to performing cardiac catheterization in appropriately selected elderly patients.