Incidence of Contrast Induced Acute Kidney Injury, Its Risk Factors and In-Hospital Outcomes in Patients Undergoing Coronary Angiography and Angioplasty

Abstract

Introduction Contrast-induced acute kidney injury (CI-AKI) is a serious complication of angiographic procedures with significant morbidity and mortality. We aimed to find the incidence, risk factors and outcomes of CI-AKI in patients who have undergone coronary angiography/angioplasty in a referral hospital in Nepal.
 MethodsIt was a descriptive observational study of consenting consecutive patients above 18 years undergoing coronary angiography/angioplasty at Manmohan Cardiothoracic Vascular and Transplant Centre, Nepal from July 2015 to September 2017. CI AKI was defined as an elevation of serum creatinine of >25% or ≥0.5 mg/dl (44 μmol/L) from baseline within 48 hour of exposure to contrast. Statistical analysis was performed using SPSS 18 software. Statistical analysis was completed using Student’s t-test, chi-square test and multivariable logistic regression analysis.
 ResultsOut of 240 patients, 156 (65%) were male, mean age was 60.36±11.29 years. Eighteen patients (7.5%) developed CI-AKI. Incidence of CI-AKI was 20% in patients with chronic kidney disease (CKD), 5.4% in diabetics, 13.6% in patients >70 years, 12.79 % in patients with anaemia and 12.3% in patients with prior contrast exposure. Multivariate logistic regression analysis found smoking and history of prior contrast exposure to be independent predictors for development of CI-AKI. Among patients with CI-AKI, one (5.88%) required dialysis and one (5.88%) died.
 ConclusionIncidence of CI-AKI after coronary angiography/angioplasty was 7.5%. Patients with prior contrast exposure and smoking were at significantly increased risk of CI-AKI; higher trend of CI-AKI was seen in patients with CKD, diabetes, elderly and anaemia.

An Overview of Contrast-induced Acute Kidney Injury

“…The prevalence of CI-AKI in India has been summarized in Table 2 for the convenience of the readers. 18–31…”

“…The prevalence of CI-AKI in India has been summarized in Table 2 for the convenience of the readers. [18][19][20][21][22][23][24][25][26][27][28][29][30][31] Indians have the highest rates of coronary artery disease (CAD) incidence, 23 and percutaneous coronary intervention (PCI) is thus a lifesaving option for many CAD patients in India and shows a crucial role in interventional cardiology. 24 According to the National Interventional Council of the Cardiological Society of India, approximately 4,38,351 PCIs are performed each year in India, and this number is on the rise.…”

“…Comorbidity is highly prevalent among patients undergoing PCI. [18][19][20][21][22][23][24][25][26][27][28][29][30][31]…”