The Incidence of Contrast-Induced Nephropathy and the Need of Dialysis in Patients Receiving Angiography: A Systematic Review and Meta-Analysis

Wu, Mei‐Yi; Lo, Wei-Cheng; Wu, Yun-Chun; Lin, Tsu-Chen; Lin, Chun‐Chi; Wu, Mai-Szu; Tu, Yu‐Kang

doi:10.3389/fmed.2022.862534

Cited by 20 publications

(11 citation statements)

References 23 publications

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“…In a recent systematic review and meta-analysis of 120 studies, the pooled proportion for CIN after angiography was 9.1% (95% CI 8.5-9.6%). 17 In several studies in Asian populations, the reported incidence of CIN was varied. In a study of 152 patients (mean age 58.5) with coronary heart disease undergoing PCI in Nepal from February 2010 to July 2010, 13.2% of the participants developed CIN after the procedure.…”

Section: Discussionmentioning

confidence: 99%

Contrast induced nephropathy in older patients undergoing coronary angiography and intervention: an observational study in Vietnam

Nguyen,

Quang,

Liu

et al. 2023

Preprint

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Background Contrast induced nephropathy (CIN) is the third common cause of hospital-acquired renal insufficiency and can negatively impact the treatment effect and increase mortality in older patients undergoing percutaneous coronary intervention (PCI). The Mehran risk score has been the most used in Vietnam. In recent years, new simpler risk prediction models have been proposed, in which the contrast volume-to-glomerular filtration rate ratio (CV/GFR ratio) is promising. This study aimed to (1) examine the incidence of CIN in older patients undergoing coronary angiography and/or PCI, (2) compare the validity of the CV/GFR ratio and the Mehran score in predicting CIN, and (3) to identify optimal cut-off points of these scales through which can help identify older patients at high risk of developing CIN. Method. This is a prospective cohort study conducted at a tertiary hospital in Vietnam from September 2019 to May 2020. Consecutive patients aged ≥ 60 who underwent coronary angiography and/or PCI were recruited. CIN was defined as a 25% increase in serum creatinine from baseline or 0.5mg/dL absolute increase in serum creatinine within 48 hours post IV contrast administration. The CV/GFR ratio and the Mehran score were applied to predict CIN risk. Receiver Operator Characteristic (ROC) was applied to evaluate the area under the curve (AUC) of the CV/GFR ratio and Mehran score in predicting CIN, and the sensitivity and specificity for common cut-off points that were suggested in previous studies. Results There were 170 participants, with a mean age of 70 years and 33.1% were women. The incidence of CIN was 9.4%. Participants with CIN had higher prevalence of chronic kidney disease, heart failure and anaemia at admission. The AUC of the CV/GFR ratio against CIN was 0.79 (95%CI 0.65–0.92), and the Mehran score against CIN was 0.65 (95%CI 0.51–0.82). Conclusion Our study found that CIN was common in older patients after PCI. The CV/GFR ratio showed a good prognostic value for predicting CIN in the study participants as the Mehran score. Further research is needed to identify the optimal cut-off values for the CV/GFR ratio in older patients in Vietnam.

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Section: Discussionmentioning

confidence: 99%

Contrast induced nephropathy in older patients undergoing coronary angiography and intervention: an observational study in Vietnam

Nguyen,

Quang,

Liu

et al. 2023

Preprint

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“…In a study by Wu et al, the incidence of CIAKI was found to be 9%, with 0.5% of patients requiring renal replacement therapy. Specifically related to coronary angiography, CIAKI occurred at a rate of 9.90%, and dialysis was needed in 0.59% of cases [ 4 ]. The likelihood of CIAKI can vary depending on the treatment setting.…”

Section: Introductionmentioning

confidence: 99%

An Investigation of Contrast-Induced Acute Kidney Injury in Patients Undergoing Percutaneous Coronary Intervention: A Cross-Sectional Study From Pakistan

Hassan,

Kumari,

Wasim

et al. 2024

Cureus

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Background and objective Contrast-induced acute kidney injury (CIAKI) is a complication observed among individuals undergoing primary percutaneous coronary intervention (PCI) and is associated with high morbidity and mortality rates. It is characterized by an elevation in serum creatinine (SCr) levels >0.5 mg/dl or a 50% relative increase in SCr from the baseline value following exposure to contrast within a 48- to 72-hour timeframe, in the absence of any alternative causes for acute kidney injury (AKI). This study aimed to assess the incidence of CIAKI in patients following PCI. Methods This prospective study was conducted from July to December 2022, after obtaining ethical approval from the institutional ethics committee (reference no: 147/LRH/MTI). A total of 159 consecutive patients who met the selection criteria were enrolled. A detailed patient and family history was obtained, and a thorough physical examination was conducted. Baseline tests, including SCr, were performed, with SCr repeated 72 hours post-PCI. All investigations were performed in the affiliated hospital's main laboratory and conducted by the same biochemist. Results The study included 159 patients presenting with myocardial infarction, angina pectoris, or ischemic features on EKG, exercise tolerance test (ETT), or echocardiogram and underwent PCI. The patients had a mean age of 51 ± 9 years, baseline SCr of 0.77 ± 0.41 mg/dl, SCr 72 hours post-procedure of 0.83 ± 0.41 mg/dl, and an average contrast volume of 128.6 ± 63 ml; 87 (55%) patients were male, and 72 (45%) were female. CIAKI was observed in 15 (9.4%) patients. Hypertension and diabetes mellitus were the most prevalent comorbidities. Male gender, diabetes mellitus, and hypertension had a clinically significant association with the development of CIAKI (p<0.05). ST-elevation myocardial infarction (STEMI) was the predominant clinical presentation in 81 (50.9%) cases. Conclusions This study examines the frequency, risk factors, and associations of CIAKI following PCI at a tertiary care hospital in a low-middle-income country. We believe our findings provide future directions for identifying and minimizing the risk of CIAKI in this patient population.

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“…However, the exposure of contrast media during coronary intervention may cause kidney injury and contrast-induced nephropathy (CIN), thereby increasing the risks of hospitalization and even mortality (3)(4)(5). Previous studies indicated an incidence of CIN around 9% and that of renal failure requiring hemodialysis up to 0.5% (6). Several risk factors including older age, hemodynamic instability, pre-existing renal failure, diabetes mellitus (DM), heart failure, and the volume of contrast media have been reported to be linked to the development of CIN (3).…”

Section: Introductionmentioning

confidence: 99%

Association of prognostic nutritional index with risk of contrast induced nephropathy: A meta-analysis

Chang

Sun

et al. 2023

Front. Nutr.

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BackgroundAlthough prognostic nutritional index (PNI) has been frequently applied in patients with malignancy or those during postoperative recovery, whether it is also an optimal indicator of the risk of contrast-induced nephropathy (CIN) in patients receiving coronary angiography remains uncertain. This meta-analysis aimed at investigating the clinical association of PNI with the risk of CIN in patients receiving coronary angiography or percutaneous coronary intervention.MethodsEmbase, Medline, Cochrane Library, and Google scholar were searched for studies until January 2023. The relationship between CIN risk and PNI (i.e., low vs. high) (primary outcome) as well as other variables (secondary outcomes) were analyzed using a random-effects model.ResultsOverall, 10 observational studies with 17,590 patients (pooled incidence of CIN: 18%) were eligible for analysis. There was a higher risk of CIN in patients with a low PNI compared to those with a high PNI [odd ratio (OR) = 3.362, 95% confidence interval (CI): 2.054 to 5.505, p < 0.0001, I2 = 89.6%, seven studies, 12,972 patients, certainty of evidence: very low]. Consistently, a lower PNI was noted in patients with CIN compared to those without (Mean difference = −5.1, 95% CI: −6.87 to −3.33, p < 0.00001, I2 = 96%, eight studies, 15,516 patients, certainty of evidence: very low). Other risks of CIN included diabetes and hypertension, while male gender and the use of statins were associated with a lower risk of CIN. Patients with CIN were older, had a higher creatinine level, and received a higher contrast volume compared to those without. On the other hand, pre-procedural albumin, estimated glomerular filtration rate, ejection fraction, hemoglobin, lymphocyte ratio were found to be lower in patients with CIN than in those without.ConclusionThis meta-analysis highlighted an inverse association of PNI with the risk of CIN, which required further studies for verification.Systematic review registration[https://www.crd.york.ac.uk/prospero/], identifier [CRD42023389185].

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The Incidence of Contrast-Induced Nephropathy and the Need of Dialysis in Patients Receiving Angiography: A Systematic Review and Meta-Analysis

Cited by 20 publications

References 23 publications

Contrast induced nephropathy in older patients undergoing coronary angiography and intervention: an observational study in Vietnam

Contrast induced nephropathy in older patients undergoing coronary angiography and intervention: an observational study in Vietnam

An Investigation of Contrast-Induced Acute Kidney Injury in Patients Undergoing Percutaneous Coronary Intervention: A Cross-Sectional Study From Pakistan

Association of prognostic nutritional index with risk of contrast induced nephropathy: A meta-analysis

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