CONTRAST - INDUCED NEPHROPATHY, OLD STORY - NEW TWISTS

  • Lulzim Brovina Special Hospital for Cardiovascular Disease “Cardio Centre” - Pristina, Kosovo
  • Ted Trajceski
  • Koco Simonovski
  • Lada Trajceska

Abstract

Aim: Radiological procedures utilizing intravascular iodinated contrast media are being widely applied for both diagnostic and therapeutic purposes and represent one of the main causes of contrast-induced nephropathy (CIN).In this hospital-based study we tried to assess predictors for development of CIN in patients undergoing cardiac catheterization.   A total of 5604 patients undergoing coronary angiogram/PCI from 2007-2017 were enrolled in the study. Multivariate predictors of CIN were identified by logistic regression using stepwise selection with entry and exit criteria of p < 0.1. A two-sided 95% confidence interval (CI) was constructed around the point estimate of the odds (OR). A p value <0.05 was considered significant. CIN occurred in 6 (1‰) patients. The mean age of patients suffering from CIN was higher than in the whole population (66.5± 31.15 vs. 58.66± 28.57, p=0.03). Characteristics of patients who developed CIN were: older age, diabetes, higher creatinine and lower EF. The incidence of CIN in patients with diabetes was higher and statistically significant (84% vs. 16%, p=0.01).  Emergency cases were at higher risk of developing CIN than elective patients (85% vs.15%, p=0.001), respectively. Diabetes, CKD and EF < 50% were independent predictors of CIN (RR 2.4, 95% CI: 1.88 - 7.132, p=0.008; RR 3.1, 95% CI: 2.17 - 6.682, p=0.003; RR 1.6, 95% CI: 2.88 - 7.132, p=0.01, respectively).The development of contrast-induced nephropathy in patients who underwent angiography and PCI was mainly related to older age, diabetes, lower GFR and heart failure, but not contrast material exposure.

References

1.Marenzi G, Cabiati A, Milazzo V, Rubino M. Contrast –induced nephropathy. Intern Emerg Med 2012; (7) 3:181-3
2. Hou SH, Bushinsky DA, Wish JB et al. Hospital-acquired renal insufficiency: a prospective study. Am J Med 1983;74:243–8
3. Nash K, Hafeez A, Hou S. Hospital-acquired renal insufficiency. Am J Kidney Dis 2002;39:930–6.
4. Mehran R, Nikolsky E. Contrast-induced nephropathy: definition, epidemiology, and patients at risk. Kidney Int Suppl 2006:S11–15.
5. Rear R, Bell R, Hausenloy DJ. Contrast-induced nephropathy following angiography and cardiac interventions. Heart 2016; 0:1-11
6. McCullough PA, Wolyn R, Rocher LL, et al. Acute renal failure after coronary intervention: incidence, risk factors, and relationship to mortality. Am J Med 1997;103:368–75.
7. Šubarić G., Gorgieva Z., Stašević S., Vasić, et al. SCREENING OF CHRONIC DISEASES AND CHRONIC DISEASE RISK FACTORS IN TWO RURAL COMMUNITIES IN KOSOVO, Cent Eur J Public Health 2010; 18 (2): 81–86
8. Bush SV, Jensen SE, Rosenberg J, Gogenur I. Prevention of contrast –induced nephropathy in STEMI patients undergoing primary percutaneous coronary intervention: a systematic review. J Interv Cardiol.2013; 26 (1):95-105
9. Silvain J, collet JP, and Montalescot G. Contrast –induced nephropathy: the sin of primary percutaneous coronary intervention? European Heart Journal 2014; 35; 1504-6
10. Burazeri G, Goda A, Sulo G, Stefa J, Roshi E, Kark JD. Conventional risk factors and acute coronary syndrome during a period of socioeconomic transition: population-based case-control study in Tirana, Albania. Croat Med J 2007;48:225-33.
11. Shoukat S, Gowani SA, Jafferani A, and Dhakam SH. Contrast-Induced nephropathy in patients undergoing percutaneous coronary intervention. Cardiology Research and Practice. Vol.2010.Article ID 649164, 12 pages. https://doi.org/10.4061/2010/649164.
12. Caspi O, Habib M, Cohen Y et al. Acute kidney injury after primary angioplasty; is contrast –induced nephropathy the culprit? J Am heart Assoc. 2017;6: e005715. DOI: 10.1161/JAHA.117.005715.
13. Shabbir A, Kitt J and Ali Omar. Contrast –induced nephropathy in PCI: an evidence-based approach to prevention. Br J cardiol 2015; 22-34
14. Sharma SK, Dubey L, Dhungel S et al. Incidence and predictors of contrast induced nephropathy after coronary intervention at college of medical sciences teaching hospital, Bharatpur. Heart Journal 2014; 11 (1):3-11
15. Gallagher S, Hassan S, Jones DA et al. Impact of contrast-induced nephropathy upon short and long-term outcomes of patients with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention. Heart 2012; 98; A70. http://dx.doi.org/ 10.1136/heartjnl-2012-301877b.124
Published
2018-12-28
How to Cite
BROVINA, Lulzim et al. CONTRAST - INDUCED NEPHROPATHY, OLD STORY - NEW TWISTS. Journal of Morphological Sciences, [S.l.], v. 1, n. 2, p. 60-64, dec. 2018. ISSN 2545-4706. Available at: <https://jms.mk/jms/article/view/27>. Date accessed: 29 mar. 2024.
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Articles