Document Type
Article
Department
Medicine
Abstract
Objective: To evaluate the frequency and risk factors associated with clinically significant contrast-induced nephropathy(CIN) in patients undergoing non-emergent coronary angiography.
Study Design: Descriptive study.
Place and Duration of Study: The Aga Khan University Hospital, Karachi, from January 2005 to December 2007.
Methodology: Case records of patients who underwent coronary angiography with a serum creatinine of ≥ 1.5 mg/dl atthe time of procedure were evaluated. Clinically significant contrast induced nephropathy (CSCIN) was defined as either doubling of serum creatinine from baseline value within a week following the procedure or need for emergency hemodialysis after the procedure.Results: One hundred and sixteen patients met the inclusion criteria. Mean age was 64.0 ± 11.5 years, 72% were males.Overall prevalence of CIN was 17% (rise of serum creatinine by ≥ 0.5 mg/dl) while that of clinically significant CIN (CSCIN) was 9.5% (11 patients). Patients with CSCIN had significantly lower left ventricular ejection fraction (p = 0.03, OR: 0.24;95% CI = 0.06 – 0.91) and higher prevalence of cerebrovascular disease (p < 0.001, OR: 14.66; 95% CI = 3.30 – 65.08).Mean baseline serum creatinine was significantly higher, 3.0 ± 1.5 vs. 2.0 ± 1.1 mg/dl (p = 0.03, OR: 1.47; 95% CI =1.03 – 2.11) whereas mean GFR estimated by Cockcroft-Gault formula was significantly lower at 25 ± 7.4 vs. 41.0 ± 14.6ml/minute (p = 0.001, OR = 0.89, 95% CI = 0.84 – 0.95) at the time of procedure in patients with CSCIN. Mean length ofhospital stay was significantly higher in this group compared to those without CIN, 9.0 ± 5.1 vs. 3.0 ± 3.2 days (p = 0.001,OR = 1.31, 95% CI = 1.12 – 1.54). Multivariate analysis revealed low GFR (p = 0.001, OR = 0.88; 95% CI = 0.82 – 0.95)and low ejection fraction (p = 0.03, OR = 0.20; 95% CI = 0.04 – 0.91) to be independent factors associated withCSCIN. No significant differences were noted between the two groups in patients with hypertension, diabetes andheart failure.
Conclusion: CSCIN is a significant concern in high risk groups despite prophylaxis. Patients with lower EF, cerebrovascular disease and low GFR at the time of procedure are more likely to have CIN.
Publication (Name of Journal)
JCPSP: Journal of the College of Physicians and Surgeons--Pakistan
Recommended Citation
Kashif, W.,
Khawaja, A.,
Hussain, S. A.
(2013). Clinically significant contrast induced acute kidney injury after non-emergent cardiac catheterization--risk factors and impact on length of hospital stay.. JCPSP: Journal of the College of Physicians and Surgeons--Pakistan, 23(12), 842-847.
Available at:
https://ecommons.aku.edu/pakistan_fhs_mc_med_med/205