Assessment of estimated GFR and clinical predictors of contrast induced nephropathy among diabetic patients undergoing cardiac catheterization

Zaki, Tarek; Samir, Ayman; Rashid, Tarek; Galal, Haitham; Samir, Wesam

doi:10.1016/j.ehj.2014.07.001

Cited by 4 publications

(8 citation statements)

References 14 publications

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“…On the other hand, in the study conducted by Uzunhasan et al [10], ACEI/ARBs use did not show statistical significance between the two studied groups. This contradiction could be explained by a small percentage of ACEI/ARBs users included in Uzunhasan et al [10] study (10%) in comparison to the present study (55%) and Zaki et al [12] study (35%).…”

Section: Discussioncontrasting

confidence: 82%

“…We found that there was statistical significance between the two studied groups regarding ACEI/ ARBs use (p = 0.005). The same was reached by Zaki et al [12] who studied the clinical predictors of CI-AKI among diabetic patients with normal SCr underwent cardiac catheterization in a total of 250 patients, he reported that patients who were receiving ACEI either as a treatment of heart failure or as a treatment for HTN were higher among those who developed CI-AKI with highly significant correlation (p < 0.001). This could be explained by the effect of chronic use of ACEI in decreasing the renal perfusion by vasoconstriction of the afferent renal arteriole.…”

Section: Discussionsupporting

confidence: 52%

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Midkine as an Early Biomarker of Contrast-induced Acute Kidney Injury in Chronic Kidney Disease Patients Undergoing Percutaneous Coronary Intervention for Acute Coronary Syndrome: A Single-center Prospective Study

Ahmed

Ibrahim

Gawish

et al. 2021

Open Access Maced J Med Sci

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Background: Contrast-induced acute kidney injury (CI-AKI), is an important complication of percutaneous coronary intervention (PCI). We aimed to study the role of serum midkine (MK) as an early biomarker of CI-AKI. Methods: We conducted a prospective observational cohort study. It includes 100 chronic kidney disease (CKD) patients with an estimated glomerular filtration rate (eGFR) <60 ml/min/1.73m2. All patients were undergoing PCI for ACS. We measured serum midkine before, 2 and 24 hours after PCI. Results: The mean age of the patients was 70.32±3.62 years, 74% males. Twenty-seven patients developed CI-AKI. The CI-AKI group has a history of diabetes mellitus (DM) and/or dyslipidemia, history of diuretics, metformin and/or angiotensin-converting enzyme inhibitors/angiotensin-receptor blockers (ACEI/ARBs) use. The CI-AKI patients have low left ventricular ejection fraction (LVEF) (EF < 45%) and low Creatinine Clearance (CrCl) before PCI. The CI-AKI received more contrast volume, had a longer duration of PCI and had high Mehran risk score after PCI. Comparison between the two studied groups regarding serum MK showed that there was a statistically significant difference regarding serum MK 2 hours after PCI. Receiver operating characteristic (ROC) curve analysis for serum MK showed that serum MK measured 2 hours after PCI was statistically significant to predict CI-AKI. Conclusion: An early Serum MK after PCI can be used as an early predictor of CI-AKI in ACS patients.

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Section: Discussioncontrasting

confidence: 82%

Section: Discussionsupporting

confidence: 52%

Midkine as an Early Biomarker of Contrast-induced Acute Kidney Injury in Chronic Kidney Disease Patients Undergoing Percutaneous Coronary Intervention for Acute Coronary Syndrome: A Single-center Prospective Study

Ahmed

Ibrahim

Gawish

et al. 2021

Open Access Maced J Med Sci

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“…[11] An RCT found age above 75 years together with diabetes mellitus to be a predictor for CIN. [22] In younger type 2 diabetic patients undergoing PCI, Zaki et al [25] reported age above 57 years to be a positive predictor for CIN. Our study population was relatively young, and fewer of our patients had multivessel disease compared with previous studies.…”

Section: Survived N=48mentioning

confidence: 99%

“…Serum albumin is an important renoprotective, anti-inflammatory and antioxidant agent acting via several mechanisms; serum albumin binds non-ceruloplasmin copper and iron, which are important in the formation of ROS, and maintains renal perfusion by dilating renal vessels via its binding to nitrogen oxide, forming S-nitro-albumin. [12,[23][24][25][26] However, during inflammation, albumin synthesis is reduced and activated neutrophils increase the levels of hypochlorous acid, which inactivates albumin. [12,13,23] Low serum albumin is probably a biomarker reflecting baseline susceptibility to acute or chronic inflammation or undernutrition.…”

Section: Survived N=48mentioning

confidence: 99%

Risk factors and outcomes of contrast-induced nephropathy in hospitalised South Africans

et al. 2016

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Despite preventive guidelines, iatrogenic contrast-induced nephropathy (CIN) ranks third as a cause of hospital-acquired AKI, impacts significantly on morbidity and mortality, and is associated with longer stays in hospitals, with higher medical costs. [1][2][3][4] The rates of CIN vary, depending on the study definitions employed and underlying risk factors, and range from 0.6% to 30% or higher among risk groups. [5][6][7][8] CIN is also associated with increased duration of hospitalisation and early and late mortality. In-hospital mortality due to CIN ranges from 7% to 22%. [9] McCullough et al. [9] reported early mortality of 1.1% in controls, 7.1% in CIN patients, and 35% in CIN patients that required dialysis. Owing to increased comorbidities, hospitalised patients have increased risk for developing CIN compared with ambulatory patients .[10]Inflammation and endothelial dysfunction, together with reactive oxygen species (ROS), are implicated in the pathogenesis of CIN. [8] Iodinated contrast media directly injures the renal tubular epithelium by producing ROS radicals that cause intra-renal vasoconstriction leading to ischaemia and death of tubular cells. [8,10,11] Serum albumin is an important antioxidant that reduces the formation of oxygen free radicals and is important in expanding intravascular volume. [12,13] However, the role of serum albumin in reducing the incidence of CIN remains unexplored.Sub-Saharan Africa has a dearth of data on rates of CIN. This study investigated the rates of CIN together with the influence of serum albumin, albuminuria, age, haemoglobin, and glomerular filtration rate (GFR) levels on CIN and patient outcomes. Methods Study design, setting and populationThis study was a prospective observational study conducted at Charlotte Maxeke Johannesburg Academic Hospital, Johannesburg, South Africa, from 1 July 2014 to 30 July 2015. Ethical approval was obtained from the human research ethics committee (HREC) of the University of the Witwatersrand and informed written consent was obtained from all patients. We consecutively recruited hospitalised patients undergoing computed tomography (CT) and angiography from the Divisions of Radiology and Cardiology, respectively. The following exclusion criteria were used: <18 years of age; evidence of pre-existing AKI (clinical or laboratory); end-stage renal disease (ESRD); renal replacement therapy (RRT); prior contrast media administration in the preceding 7 days; pregnancy; or incomplete data. Study proceduresThe study physician reviewed participants' medical records and examined the participants in order to determine pre-existing risk factors for CIN. The medical records were reviewed to determine patient duration of hospitalisation, dialysis requirements and mortality. Study phlebotomists collected blood samples prior to and post contrast media administration. Pre contrast, urine was collected and analysed for microalbuminuria using the Chemistrip Micral 30 immune assay test (Roche 11544039172). Serum creatinine was analysed using the Jaff...

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“…PC-AKI incidence was the main outcome studied (19 studies), while the incidence of ADRs or HSRs was studied in nine studies [ 28 , 30 , 33 – 39 ]. Coronary angiography was the main type of procedure (19 studies) [ 15 – 20 , 22 – 25 , 27 , 28 , 30 – 32 , 35 , 36 , 39 ] followed by peripheral (five studies) [ 15 , 21 , 25 , 33 , 34 ] and cerebral angiography (three studies) [ 26 , 29 , 38 ] (Table 1 ).…”

Section: Resultsmentioning

confidence: 99%

A systematic review of the incidence of hypersensitivity reactions and post-contrast acute kidney injury after ioversol: part 2—intra-arterial administration

et al. 2022

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Objectives To evaluate the incidence of adverse drug reactions (ADRs), including hypersensitivity reactions (HSRs) and post-contrast acute kidney injury (PC-AKI), after intra-arterial (IA) administration of ioversol. Methods and materials A systematic literature search was performed (1980–2021) and studies documenting IA use of ioversol, and reporting safety outcomes were selected. Key information on study design, patients’ characteristics, indication, dose, and type of safety outcome were extracted. Results Twenty-eight studies (including two pediatric studies) with 8373 patients exposed to IA ioversol were selected. Studies were highly heterogenous in terms of design, PC-AKI definition, and studied population. PC-AKI incidence after coronary angiography was 7.5–21.9% in a general population, 4.0-26.4% in diabetic patients, and 5.5–28.9% in patients with chronic kidney disease (CKD). PC-AKI requiring dialysis was rare and reported mainly in patients with severe CKD. No significant differences in PC-AKI rates were shown in studies comparing different iodinated contrast media (ICM). Based on seven studies of ioversol clinical development, the overall ADR incidence was 1.6%, comparable to that reported with other non-ionic ICM. Pediatric data were scarce with only one study reporting on PC-AKI incidence (12%), and one reporting on ADR incidence (0.09%), both after coronary angiography. Conclusions After ioversol IA administration, PC-AKI incidence was highly variable between studies, likely reflecting the heterogeneity of the included study populations, and appeared comparable to that reported with other ICM. The rate of other ADRs appears to be low. Well-designed studies are needed for a better comparison with other ICM. Key Points • PC-AKI incidence after IA administration of ioversol appears to be comparable to that of other ICM, despite the high variability between studies. • The need for dialysis after IA administration of ioversol is rare. • No obvious difference was found regarding the safety profile of ioversol between IA and IV administration.

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Assessment of estimated GFR and clinical predictors of contrast induced nephropathy among diabetic patients undergoing cardiac catheterization

Cited by 4 publications

References 14 publications

Midkine as an Early Biomarker of Contrast-induced Acute Kidney Injury in Chronic Kidney Disease Patients Undergoing Percutaneous Coronary Intervention for Acute Coronary Syndrome: A Single-center Prospective Study

Midkine as an Early Biomarker of Contrast-induced Acute Kidney Injury in Chronic Kidney Disease Patients Undergoing Percutaneous Coronary Intervention for Acute Coronary Syndrome: A Single-center Prospective Study

Risk factors and outcomes of contrast-induced nephropathy in hospitalised South Africans

A systematic review of the incidence of hypersensitivity reactions and post-contrast acute kidney injury after ioversol: part 2—intra-arterial administration

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