RESEARCH PAPER
Risk factors for contrast induced nephropathy in patients undergoing percutaneous transluminal coronary angioplasty
1
Katedra i Klinika Kardiologii Uniwersytetu Medycznego w Lublinie
2
Samodzielna Pracownia Medycyny Katastrof Uniwersytetu Medycznego w Lublinie
Med Og Nauk Zdr. 2012;18(2):101-105
KEYWORDS
ABSTRACT
Introduction and aim of the study:
Contrast-induced nephropathy (CIN) is the third most common cause of acute kidney injury in hospitalized patients, responsible for increased mortality, especially in patients with cardiovascular disease. The aim of this study was to measure the incidence of CIN after elective percutaneous transluminal coronary angioplasty (PTCA) and the potential significance of some factors which are or may be important in the pathogenesis of this complication.
Material and Methods:
The study group included 43 patients, 60 – 80-years-old, an average of 66.36 ± 8.82, with recognized coronary artery disease, undergoing elective PTCA. Renal function was assessed based on the eGFR before and 24 hours after PTCA procedure. The three stages nephropathy grading system (0-I-II) was used.
Results:
As many as 29.5% of the patients satisfied CIN criteria. Criterion of a mild (Grade I) nephropathy was found in 20.5% of patients, significant (Grade II) in 9.1% of patients. A slight increase in serum creatinine (Grade 0) was observed in 41.9% of the patients. Statistical analysis showed that age and PTCA within the left main coronary artery (LCA) were independent risk factors for CIN.
Conclusions:
Contrast-induced nephropathy is a frequent complication of angioplasty procedures. Older patients and patients undergoing the procedure of PTCA within the LCA require special care during the treatment with the use of contrast.
Contrast-induced nephropathy (CIN) is the third most common cause of acute kidney injury in hospitalized patients, responsible for increased mortality, especially in patients with cardiovascular disease. The aim of this study was to measure the incidence of CIN after elective percutaneous transluminal coronary angioplasty (PTCA) and the potential significance of some factors which are or may be important in the pathogenesis of this complication.
Material and Methods:
The study group included 43 patients, 60 – 80-years-old, an average of 66.36 ± 8.82, with recognized coronary artery disease, undergoing elective PTCA. Renal function was assessed based on the eGFR before and 24 hours after PTCA procedure. The three stages nephropathy grading system (0-I-II) was used.
Results:
As many as 29.5% of the patients satisfied CIN criteria. Criterion of a mild (Grade I) nephropathy was found in 20.5% of patients, significant (Grade II) in 9.1% of patients. A slight increase in serum creatinine (Grade 0) was observed in 41.9% of the patients. Statistical analysis showed that age and PTCA within the left main coronary artery (LCA) were independent risk factors for CIN.
Conclusions:
Contrast-induced nephropathy is a frequent complication of angioplasty procedures. Older patients and patients undergoing the procedure of PTCA within the LCA require special care during the treatment with the use of contrast.
REFERENCES (21)
1.
Lindholt JS. Radiocontrast Induced Nephropathy. Eur J Vasc Endovasc Surg. 2003; 25: 296-304.
2.
Harjai K, Raizada A, Shenoy C. A Comparison of Contemporary Definitions of Contrast Nephropathy in Patients Undergoing Percutaneous Coronary Intervention and a Proposal for a Novel Nephropathy Grading System. Am J Cardiol. 2008; 101: 812 819.
3.
Aguiar-Souto P, Valero-Gonzalez S. When to Test Renal Function to Disclose Contrast-Induced Nephropathy. Am J Cardiol. 2008; 101 (6): 812-9.
4.
Gorczyca-Michta I, Wożakowska-Kapłon B. Nefropatia kontrastowa u pacjentów poddawanych przezskornym interwencjom wieńcowym. Post Kardiol Interw. 2011; 7, 2 (24): 165-172.
5.
Manna LG, Goffredo L, Capecchi A, et al. Risk for Contrast Nephropathy in Patients Undergoing Coronarography. Artif Organs. 2010; 34 (6): 193-199.
6.
Hernandez F, Mora L, Garcia Tejada J et al. Comparison of Iodixanol and Ioversol for the Prevention of Contrast-Induced Nephropathy in Diabetic Patients After Coronary Angiography or Angioplasty. Rev Esp Cardiol. 2009; 62 (12): 1373-80.
7.
Wong PCY, Li Z, Guo J, Zhang A. Pathophysiology of contrast-induced nephropathy. Int J Cardiol. 2011; 12.
8.
Anderson S, Eldadah B, Halter JB. Acute Kidney Injury in Older Adults. J Am Soc Nephrol. 2011; 22: 28-28.
9.
Wijns W, Kolh P, Danchin N et al. Wytyczne Europejskiego Towarzystwa Kardiologicznego dotyczące rewaskularyzacji mięśnia sercowego. Kardiol Pol. 2010; 68: 569-638.
10.
Mehran R, Caixeta A. N-acetylocysteine In Preventing Contrast- -Induced Nephrpoathy. To Give, or Not To Give: That is the Question. Rev Esp Cardiol. 2010; 63: 9-11.
11.
Amin AP, Spertus J, Reid KJ et al. The prognostic importance of worsening renal function Turing an acute myocardial infarction on long-term mortality. Am H J. 2010; 160: 1065-71.
12.
Chong E, Poh KK, Liang S, Tan HC. Risk Factors and Clinical Outcomes for Contrast-Induced Nephropathy After Percutaneous Coronary Intervension in Patients with Normal Serum Creatinine. Ann Acad Med. Singapore. 2010; 39: 374-80.
13.
Iakovou I, Dangas G, Mehran R, et al. Impact of Gender on the Incidence and Outcome of Contrast-Induced Nephropathy After Percutaneous Coronary Intervention. J Invasive Cardiol. 2003; 15 (1): 18-22.
14.
Cho JY, Jeong MH, Park SH et al. Effect of contrast-induced nephropathy on cardiac outcomes after use nonionic isosmolar contrast media during coronary procedure. J Cardiol. 2010; 56: 300-306.
15.
Sudarsky D, Nikolsky E. Contrast-induced nephropathy in interventional Cardiology. Int J Nephrol Renovasc Dis. 2011; 4: 85-99.
16.
Senoo T, Motohiro M, Kamihata H et al. Contrast-Induced Nephropathy in Patients Undergoing Emergency Percutaneous Coronary Intervension for Acute Coronary Syndrome. Am J Cardiol. 2010; 105: 624-6.
17.
Marenzi G, Lauri G, Assanelli E et al. Contrast-Induced Nephropathy in Patients Undergoing Primary Angioplasty for Acute Myocardial Infarction. J Am Coll Cardiol. 2004; 44: 1780-5.
18.
Jabara R, Radhika RG, Lakshman K et al. Impact of the Definition Utilized on the Rate of Contrast-Induced Nephropathy in Percutaneous Coronary Intervension. Am J Cardiol. 2009; 103: 1657-1662.
19.
Weisbord SD, Chen H, Stone R, Kip KE et al. Associations of Increases in Serum Creatinine with Mortality and Length of Hospital stay after Coronary Angiography. J Am Soc Nephrol. 2006; 17: 2871-2877.
20.
Klinger M, Penar J. Ostra niewydolność nerek po stosowaniu radiologicznych środkow cieniujących. W: Ostra niewydolność nerek, red. Matuszkiewicz-Rowińska J. Wyd 1 Warszawa: PZWL; 2006: 214-222.
21.
Laville M, Juillard L. Contrast-induced acute kidney injury: how should AT-risk patients be identified and manager? J Nephrol. 2010; 23 (04): 387-398.
Share
RELATED ARTICLE
| eISSN: | 2084-4905 |
| ISSN: | 2083-4543 |
We process personal data collected when visiting the website. The function of obtaining information about users and their behavior is carried out by voluntarily entered information in forms and saving cookies in end devices. Data, including cookies, are used to provide services, improve the user experience and to analyze the traffic in accordance with the Privacy policy. Data are also collected and processed by Google Analytics tool (more).
You can change cookies settings in your browser. Restricted use of cookies in the browser configuration may affect some functionalities of the website.
You can change cookies settings in your browser. Restricted use of cookies in the browser configuration may affect some functionalities of the website.
