Partnering for Optimal Patient Care

ACIST Medical Systems provides a suite of diagnostic tools
to help you provide optimal care to your patients.
Education is a key aspect of our partnership.
Clinical studies on the short and long-term impact of COVID-19 are being publisheddaily. There is a large body of clinical evidence published on COVID-19 and kidney
health. The following is a summary based on a review of the publications cited by
the National Kidney Foundation, CDC, and other professional societies:

SCAI/ACC/AMA guidelines
recommend that
contrast dose
for CKD patientsshould be limited
as much as
clinically possible
as it has been clearlyshown to reduce
the risk of CI-AKI.10• A meta-analysis of over 30 studies demonstrates that COVID-19 is tough onorgans, including kidneys.1• Acute kidney injury (AKI) has been observed in COVID-19 patients, even among
non-elderly, otherwise healthy adults.2 A recent study reported that of 3993 New Yorkpatients hospitalized for COVID-19, 46% experienced AKI; among survivors, 35% had
not recovered baseline kidney function at the time of discharge.4• Among COVID-19 patients, there is a strong correlation between cardiac injury
and kidney injury.3• An analysis of over 1.7 million US veterans, including 89,216 30-day COVID-19 survivors,
found that COVID-19 survivors had a higher risk of AKI, ESKD (end stage renal disease),
MAKE (major adverse kidney event) and eGFR decline of ≥30%, ≥40%, and ≥50%.5• AKI is present in up to 30% of hospitalized patients and it is uncertain how
many will regain their kidney function.6 According to the National KidneyFoundation, after COVID-19 recovery, these patients are at increased risk ofdeveloping Chronic Kidney Disease.2• Before COVID-19, ~30% of patients presenting for coronary angiography
procedures were at risk for post-procedure CI-AKI.7 With the impact of COVID-19,
this population may increase, as COVID-19 survivors who experienced AKI orblood and/or protein in their urine are at an elevated risk of developing chronic
kidney disease.2

ACIST CVi™ Can Help Protect Renal Function During Angiography
For over 20 years, ACIST CVi has given physicians the ability to obtain quality
angiographic images with precise8 contrast delivery and tracking, reducing thepotential risk for CI-AKI compared to hand manifold.9
SCAI/ACC/AMA guidelines recommend that contrast dose for CKD patients should
be limited as much as clinically possible as it has been clearly shown to reduce therisk of CI-AKI.10

Visit Our Website
for Current Data
For a current list of thepublications on COVID-19
and kidney health, please visit:www.acistmedical.com/COVID

Bracco GroupA November 2019 JAMA article demonstrates that the majority of PCI patients arestill receiving greater than 150 cc of contrast per procedure.11
CVi is a proven technology that results in a 22%9 reduction in delivered contrast
over hand manifold.
ACIST CVi can help reduce and track contrast delivery during angiography
procedures without adding time to your busy cath lab workflow and withtechnology you may already have at your hospital.9

References
1.  Wang, Xinhui, et al. “Comorbid Chronic Diseases and Acute Organ Injuries Are Strongly Correlated with Disease Severity and Mortality among
COVID-19 Patients: A Systemic Review and Meta-Analysis.” Research 2020 (2020): 2402961. https://www.ncbi.nlm.nih.gov/pmc/articles/
PMC7187729/
2.  National Kidney Foundation, https://www.kidney.org/coronavirus/kidney-disease-covid-19
3.  Shi, Shaobo, et al. “Association of cardiac injury with mortality in hospitalized patients with COVID-19 in Wuhan, China.” JAMA cardiology (2020).
https://jamanetwork.com/journals/jamacardiology/article-abstract/2763524
4.  Chan, Lili, et al. “AKI in hospitalized patients with COVID-19.” Journal of the American Society of Nephrology 32.1 (2021): 151-160.
5.  Bowe, Benjamin, et al. “Kidney outcomes in long COVID.” Journal of the American Society of Nephrology (2021).
6.  Johns Hopkins, https://www.hopkinsmedicine.org/health/conditions-and-diseases/coronavirus/coronavirus-kidney-damage-caused-by-covid19
7.  Tsai T, et al., Contemporary Incidence, Predictors, and Outcomes of Acute Kidney Injury in Patients Undergoing Percutaneous Coronary
Interventions. JACC, Vol. 7, Jan. 2014.
8. Data on File.
9.  Minsinger KD, Kassis HM, Block CA, Sidhu M, Brown JR (2014) Meta-analysis of the effect of automated contrast injection devices versus
manual injection and contrast volume on risk of contrast-induced nephropathy. Am J Cardiol 113 (1): 49-53.
10. Writing Committee Members, et al. “2011 ACCF/AHA/SCAI guideline for percutaneous coronary intervention: a report of the American Collegeof Cardiology Foundation/American Heart Association Task Force on Practice Guidelines and the Society for Cardiovascular Angiography andInterventions.” Circulation 124.23 (2011): e574-e651. ahajournals.org/doi/full/10.1161/CIR.0b013e31823ba622
11. Huang, Chenxi, et al.Development and Validation of a Model for Predicting the Risk of Acute Kidney Injury Associated With Contrast VolumeLevels During Percutaneous Coronary Intervention. JAMA network open 2.11 (2019): e1916021-e1916021. PubMed ID: 31755952

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