Contrast induced nephropathy among patients with normal renal function undergoing coronary angiography

Abstract

Introduction: Although contrast induced nephropathy (CIN) is a well-known complication of radiocontrast media administration among patients with underlying renal insufficiency, however the data about CIN among patients with normal renal function are few and it seems that CIN often remained under-diagnosed among these patients. Objectives: The aim of present study was evaluation of CIN in diabetic and nondiabetic patients with normal renal function undergoing coronary angiography. Patients and Methods: This cross-sectional and prospective study has conducted on patients with normal renal function candidate for diagnostic coronary angiography at Imam hospital, Ahvaz, Iran from October 2010 to February 2011. CIN defined as an increase in serum creatinine (sCr) >0.5 mg/dL after two days of contrast administration. A standardized questionnaire was used to collect demographics, clinical and laboratory data. Results: A total of 254 patients (140 males and 114 Females with mean age of 56.6 ± 11.9 years) were included in the study. Of them, 60 patients (23.6%) had congestive heart failure (CHF) and 57 patients (22.4%) had diabetes mellitus (DM). The mean sCr levels before contrast administration in men and women were 1.05 ± 0.22 and 0.93 ± 0.17 mg/dL respectively. In overall CIN occurred in 27 patients (10.6%) with no difference between males and females (P = 0.386) and in patients with or without CHF (P = 0.766). There was a significant association between CIN and DM (P = 0.001) and mean volume of contrast administration (P = 0.001). Conclusion: Although CIN is a common problem in patients with diabetic nephropathy undergoing coronary angiography, diabetic patients without diabetic nephropathy and also patients without DM who had normal renal function are also at risk of contrast nephropathy.

Measurement of urinary kidney injury molecule-1 as a predictive biomarker of contrast-induced acute kidney injury

“…In the present study, the incidence of CIN occurred in 19 ( results in the present study showed even patients with normal kidney function have the development of CI-AKI after exposure to contrast media; this finding is agreed with Assareh et al 13 Recent study carried by Sato et al, showed that CIN was an independent predictor of subsequent renal events in the patients who underwent cardiac catheterization. 14 The risk of CI-AKI due to coronary angiography increases dramatically with low kidney function.…”

Contrast-Induced Nephropathy Among Patients Undergoing Cardiac Catheterization

“…This can be attributed to the volume of contrast agent in these procedures, as therapeutic intervention take longer duration that needs larger volume of contrast agent; this is supported by a study of Kane et al [10]. Similarly, in a retrospective study of nearly 104 patients who underwent diagnostic or therapeutic PCI, those with duration of procedure more than 90 minutes shown a higher risk of CIN development, also shown that use of more than 200 ml of contrast media was associated with further risk for development of CIN [10], and other studies correspond to these findings [30,33,39].…”

The Role of Xuefu Zhuyu Decoction in Prevention of Contrast‐Induced Nephropathy after Percutaneous Coronary Intervention

“…At present, hydration therapy is generally recognized as the routine measure to prevent CIN. Although adequate hydration therapy reduces the concentration and hyperosmotic state of the contrast media [29], the incidence of CIN after PCI is still high [30] and hydration therapy cannot decrease the production of oxygen-free radicals. As the contrast media can cause a series of oxidative stress reaction, several compounds with properties of antioxidant stress such as sodium bicarbonate, N-acetylcysteine, ascorbic acid, and statins have been investigated [31].…”