DyeVert Systems for reducing the risk of acute kidney injury in coronary and peripheral angiography

1.1 DyeVert Systems show promise for reducing the risk of acute kidney injury (AKI) in coronary and peripheral angiography after using contrast media. However, there is not enough evidence to support the case for routine adoption. This is because there is not enough good-quality evidence that using the system reduces AKI incidence after having contrast media.

1.2 A randomised controlled trial is recommended to compare DyeVert Systems with standard care. The aim of this research would be to address uncertainties about whether using DyeVert Systems reduces AKI incidence and rate of renal replacement therapy after using contrast media. This must include people with stage 4 chronic kidney disease (with an estimated glomerular filtration rate [eGFR] under 30 ml/min/1.73 m²), who are at risk of AKI and need elective coronary or peripheral angiography.

Find out details of required outcomes in the section on further research in this guidance.

Why the committee made these recommendations

Current standard care to reduce the risk of AKI in people having contrast dye (media) during coronary and peripheral angiography involves giving them fluids.

Clinical evidence shows that DyeVert Systems reduce the amount of contrast that enters the blood vessel. Contrast dye is thought to increase the risk of AKI in people at risk. There is some evidence to suggest that, by reducing the amount of contrast media given during coronary angiography, DyeVert Systems could reduce AKI risk. But stronger evidence is needed to be certain of a causal relationship. Also, almost all the current evidence is from coronary angiography, which may not apply to peripheral angiography.

Because of the uncertainty about whether DyeVert Systems reduce AKI, any potential cost savings are also uncertain.

Therefore, NICE recommends further research.