Obesity as a Risk Factor for Radiographic Contrast-Induced Nephropathy

Abstract

Contrast-induced nephropathy (CIN) is common. Risk factors include preexisting renal impairment, diabetes, elderly age, and dehydration. In a single-centre prospective study, we investigated which factors are implicated for CIN in patients with peripheral arterial disease due for angiography. Serum creatinine was measured before, 1, 2, and 7 days post-angiography. We also considered the chronic kidney disease stage of the patients at admission and 48 hours post-contrast. All patients received 500 mL normal saline pre- and post-angiography and a low-osmolality contrast medium. 6 of 94 patients developed CIN: 1 required dialysis and 1 died partly due to renal failure. Only 2 factors were associated with CIN: body mass index (BMI; P = .019) and kidney function ( P = .001); 4 of 6 patients with CIN were obese (BMI ≥30) and only 2 were nonobese ( P = .0092). Diabetes, contrast volume, and age were not significant risk factors. Our results confirm renal impairment raises the risk of CIN. To our knowledge, we report for the first time that obesity may be a risk factor for CIN. Pending confirmatory studies and given the rising prevalence of obesity, this finding could help identify at-risk patients and hence reduce the burden of CIN.

The relationship between H2FPEF score and contrast induced nephropathy in patients with ST elevation myocardial infarction

“…Kabeer MA, et al showed that obesity is a risk factor for contrast induced nephropathy. 14 The close relationship between atrial fibrillation and CIN has been demonstrated in recent studies. 15 , 16 Also it has been demonstrated that hypertension, heart failure, age, nephrotoxic drugs, decreased intravascular volume, play important roles in the development of CIN.…”

H2FPEF Score and Contrast-Induced Nephropathy in Patients With Acute Coronary Syndrome Undergoing Percutaneous Coronary Intervention

“…In addition, similar to the results of previous studies, CIN was found to be higher in patients with AF and anterior MI (AMI) in our study. 4,13…”

“…In addition, similar to the results of previous studies, CIN was found to be higher in patients with AF and anterior MI (AMI) in our study. 4,13 The pathophysiology behind the development of CIN is not yet fully understood. Recent studies have argued that factors such as increased systemic inflammation, oxidative stress, acidosis, and hyperglycemia play a role.…”

“…These parameters are separately proven risk factors for renal dysfunction, and CIN. [9][10][11][12][13] Our hypothesis is to determine whether the H 2 FPEF score is a good and accurate indicator of the development of CIN in patients presenting with ACS and undergoing PCI. There is no study investigating the relationship between the H 2 FPEF score and CIN.…”

N-acetylcysteine in the Prevention of Contrast-induced Acute Kidney Injury: a Systematic Review and Meta-analysis of Randomized Controlled Clinical Trials

“…На это направление исследований было выделено огромное количество средств, и очень большое количество пациентов подверглось исследуемым вмешательствам, включая N-ацетилцистеин, бикарбонат натрия, жидкостную нагрузку, статины, витамин С, вазоактивные препараты, теофиллин, прекондиционирующую ишемию и заместительную почечную терапия, но ни один из них не лишен побочных эффектов [4]. Помимо перипроцедурной гидратации, которая, по-видимому, снижает, но не полностью предотвращает риск повреждения почек после введения рентгеноконтрастных средств, результаты применения других препаратов, таких как дофамин, маннит, Nацетилцистеин и каптоприл, аллопуринол неоднозначны [5][6][7]. В клинических рекомендациях KDIGO по ОПП с целью профилактики КИ-ОПП наряду с внутривенным восполнением объема циркулирующей крови физиологическим раствором натрия хлорида или растворами натрия бикарбоната рекомендуется использовать пероральную терапию N-ацетилцистеином в сочетании с внутривенным введением изотонических растворов кристаллоидов [8].…”