2016, Number 2
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Rev Mex Cardiol 2016; 27 (2)
Contrast-induced nephropathy in patients undergoing percutaneous coronary intervention
Pérez-Topete SE, Miranda-Aquino T, Gasca-Luna K, Guerra-Villa MN, Elizondo-Adamchik HE
Language: English
References: 20
Page: 64-70
PDF size: 215.26 Kb.
ABSTRACT
Introduction: Contrast-induced nephropathy (CIN) is defined as the impairment of renal function and is measured as either a 25% increase in serum creatinine (SCr) from baseline or 0.5 mg/dL increase in absolute value, within 48-72 hours of intravenous contrast administration.
Objectives: Objectives were to calculate incidence of CIN and to describe the clinical and periprocedural risk factors for patients receiving contrast media. Secondary objective was to compare mortality between group 1 and group 2.
Material and methods: In a retrospective, observational, descriptive cohort study, patients who were admitted to the hospital for diagnostic and/or therapeutic coronary angiography between January 2014 to September 2015, the serum creatinine and glomerular filtration rate (GFR) prior to angiography and 72 hours later was measured.
Results: 70 patients were included, of which 14.2% developed CIN. The leading risk factors for developing AKI were: age › 65 years (OR 12.6, CI95 1.6-105.9, p = 0.03); the presence of anemia (OR 7.5, CI95 1.8-31.2, p = 0.006); and procedural time more than 90 minutes (OR 16, CI95 3.1-85.3, p = 0.001). Higher mortality was observed in the NIC group (30% vs. 1.6%, p = 0.004).
Conclusions: The incidence is higher than in the literature review. The leading associated risk factors were age › 65, anemia and procedural time › 90 minutes. The development of CIN carries a higher mortality.
REFERENCES
Mehran R, Nikolsky E. Contrast-induced nephropathy: definition, epidemiology, and patients at risk. Kidney International. Supplement. 2006; 100: S11-S15.
Tepel M, Aspelin P, Lameire N. Contrast-induced nephropathy: A clinical and evidence-based approach. Circulation. 2008; 113: 1799-1806.
Aspelin P, Aubry P, Fransson SG, et al. Nephrotoxic effects in high-risk patients undergoing angiography. N Engl J Med. 2003; 348-349.
Leow K, Wu Y, Tan C. Renal-related adverse effects of intravenous contrast media in computed tomography. Singapore Medical Journal. 2015; 56 (4): 186-193.
Berg KJ. Nephrotoxicity related to contrast media. Scand J Urol Nephrol. 2000; 34: 317-322.
Bouzas-Mosquera A, Vazquez-Rodrıguez JM, Calvino-Santos R, Peteiro-Vazquez J, Flores-Ríos X, Marzoa-Rivas R et al. Nefropatía inducida por contraste y fracaso renal agudo tras cateterismo cardiaco urgente: incidencia, factores de riesgo y pronóstico. Rev Esp Cardiol. 2007; 60: 1026-1034.
Rundback JH, Nahl D, Yoo V. Contrast-induced nephropathy. Journal of Vascular Surgery. 2011; 54 (2): 575-579.
Brown JR, Malenka DJ, DeVries JT, Robb JF, Jayne JE, Friedman BJ et al. Transient and persistent renal dysfunction are predictors of survival after percutaneous coronary intervention: Insights from the Dartmouth Dynamic Registry. Catheter Cardiovasc Interv. 2008; 72 (3): 347-354.
Gul I, Zungur M, Tastan A, Okur FF, Damar E, Uyar S et al. The importance of contrast volume/glomerular filtration rate ratio in contrast-induced nephropathy patients after transcatheter aortic valve implantation. Cardiorenal Medicine. 2015; 5 (1): 31-39.
Lameire N, Kellum JA, KDIGO AKI Guideline Work Group. Contrast-induced acute kidney injury and renal support for acute kidney injury: a KDIGO summary (Part 2). Critical Care. 2013; 17 (1): 205.
Rihal CS, Textor SC, Grill DE, Berger M, Ting H, Best P et al. Incidence and prognostic importance of acute renal failure after percutaneous coronary intervention. Circulation 2002; 105: 2259-2264.
Gruberg L, Mintz GS, Mehran R, Gangas G, Lansky AJ, Kent KM et al. The prognostic implications of further renal function deterioration within 48 h of interventional coronary procedures in patients with preexistent chronic renal insufficiency. J Am Coll Cardiol. 2000; 36: 1542-1548.
Wong GTC, Irwin MG. Contrast-induced nephropathy. British Journal of Anaesthesia. 2007; 99 (4): 474-483.
Solomon RJ, Mehran R, Natarajan MK, Doucet S, Katholi RE, Staniloae CS et al. Contrast-induced nephropathy and long-term adverse events: Cause and effect. Clinical Journal of the American Society of Nephrology. 2009; 4 (7): 1162-1169.
Wichmman JL, Katzberg RW, Litwin SE, Zwerner P, Cecco CN, Vogl TJ et al. Contrast-Induced Nephropathy. Circulation. 2015; 132: 1931-1936.
Marenzi G, Lauri G, Assanelli E, Campodonico J, De Metrio M, Marana I et al. Contrast-induced nephropathy in patients undergoing primary angioplasty for acute myocardial infarction. Journal of the American College of Cardiology. 2004; 44 (9): 1780-1785.
Saito Y, Watanabe M, Aonuma K, Hirayama A, Tamaki N, Tsutsui H et al. Proteinuria and reduced estimated glomerular filtration rate are independent risk factors for contrast-induced nephropathy after cardiac catheterization. Circulation Journal. 2015; 79: 1624-1640.
Brar SS, Hiremath S, Dangas G, Mehran R, Brar SK, Leon MB. Sodium bicarbonate for the prevention of contrast induced-acute kidney injury: a systematic review and meta-analysis. Clinical Journal of the American Society of Nephrology : CJASN. 2009; 4 (10): 1584-1592.
De Agustín JA, Carda R, Manzano MC, Ruiz-Mateos B, García-Rubira JC, Fernández-Ortiz A et al. Aclaramiento de creatinina y nefropatía por contraste en pacientes con creatinina normal. Revista Española de Cardiología. 2007; 60 (07): 772-776.
Newhouse JH, Kho D, Rao QA, Starren J. Frequency of serum creatinine changes in the absence of iodinated contrast material: implications for studies of contrast nephrotoxicity. AJR Am J Roentgenol. 2008; 191: 376.