Contrast-Induced Nephropathy in patients submitted to percutaneous coronary intervention: an integrative review (original) (raw)
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Revista portuguesa de cardiologia : orgao oficial da Sociedade Portuguesa de Cardiologia = Portuguese journal of cardiology : an official journal of the Portuguese Society of Cardiology, 2018
Contrast-induced nephropathy (CIN) features as an increasingly frequent diagnosis in the field of interventional cardiology. This is due to increased use of iodine-based contrast agents in cardiovascular diagnostic and therapeutic procedures performed in patients with multiple comorbidities, as well as in ever more complex clinical and angiographic settings that require lengthy or staged procedures. CIN is estimated to be the third leading cause of renal failure among in-patients, accounting for 11-12% of cases. 1 According to some studies, its incidence can reach 25-30% in elderly patients, especially those with diabetes, ST-segment elevation acute coronary syndrome, left ventricular dysfunction or chronic renal failure (CRF). A subgroup at greater risk of developing CIN is those with concomitant diabetes and CRF.
Contrast Induced Nephropathy and its predictors after Primary Percutaneous Intervention
Nepalese Heart Journal, 2021
Background and Aims: Worldwide many patients are receiving intravascular contrast media (CM) during interventional procedures. Contrast media are used to enhance visualization and guide percutaneous coronary interventions (PCI).1 However, the use of CM also carries the risk of complications and it is important to be aware of these complications. Complications with CM range from mild symptoms to life-threatening conditions like anaphylaxis, hypotension and renal dysfunction and contrast-induced nephropathy (CIN) is one of them which can have both short and long term consequences.2 This study aimed to know the incidence of CIN in our center and possible predictors associated with it. Methods: This is the single hospital based cross sectional observational study. Patients undergoing primary PCI were enrolled in the study. All the patients underwent thorough history taking and physical examination. Baseline required laboratory investigations were sent. Electrocardiogram and echocardiogr...
Pakistan Journal of Medical and Health Sciences
Objective: To assess the prevalence of contrast-induced nephropathy and its associated risk factors in patients undergoing multi-vessel percutaneous coronary intervention (PCI). Study Design: Observational/ Prospective study Place and Duration: Armed forces institute of cardiology & National Institute of heart diseases, Rawalpindi, during from the period September 2019 to Feb 2020. Methods: There were 112 patients of both genders with ages 18-75 years were presented in this study. Data on enrolled patients' age, gender, BMI, marital status and education level were collected after receiving written permission from each patient. This research included people who had undergone a percutaneous coronary intervention. Serum creatinine >0.5mg/dl from the baseline value was classified as contrast induced nephropathy. CIN-related risk factors were studied. Data was analyzed using SPSS 24.0. Results: The mean age of the patients was 51.6±9.53 years and had mean BMI 23.5±15.67 kg/m2. Maj...
Journal of Medicine, University of Santo Tomas, 2018
Introduction The rapidly growing number of percutaneous coronary interventions has led to a considerable improvement in the outcome of patients with acute coronary syndromes, yet concurrently exposing patients to enormous volumes of contrast media with the inherent risk of renal function impairment. Objective To determine the incidence of contrast induced nephropathy of patients admitted at University of Santo Tomas Hospital (USTH) who underwent coronary angiography with or without Percutaneous Transluminal Coronary Angioplasty (PTCA). Methodology This is a retrospective, descriptive study including patients aged 18 years and above, of any gender, admitted at the USTH from January 1, 2016 to December 31, 2016, who underwent coronary angiography with or without PTCA with baseline and follow up creatinine levels 48-72 hours after the procedure. Data were retrieved by review of medical records of these patients. Results Three out of 78 patients (3.8%) had elevated creatinine but all three patients also underwent major surgery within 48 hours after coronary angiography which could explain the renal impairment. Conclusion Although contrast induced nephropathy was described as the third most common cause of new Acute Kidney Injury in hospitalized patients, it was accordingly nil among those who underwent coronary angiography at USTH from January to December 2016. Benefi ts and risks of undergoing coronary angiography should always be weighed
Journal of Interventional Cardiology, 2010
therapy. Methods: A cohort of 8,798 patients who underwent PCI from May 2000 to April 2008 was enrolled. We divided patients into 3 groups. A: STEMI patient undergoing primary PCI; B: UA/NSTEMI patients undergoing early PCI; C: Patients without MI undergoing elective PCI. Pre-PCI saline hydration was given to group B and C if baseline glomerular filtration rate (GFR) <60 ml/min/1.73 m 2 . Results: Mean age was 57.4 years; 35.9% was diabetics. Incidence of CIN were 12.0%, 9.2%, and 4.5%, in group A, B and C (P = <0.0005). CIN correlated with higher mortality (15.5% vs. 1.3%, P < 0.0005) at 1 month. The important predictors of CIN were age >70, female gender, anemia, low systolic BP < 100 mmHg, high creatinine kinase level, abnormal LVEF, baseline renal impairment, MI and insulin dependent diabetes. Incidence of CIN in patients with GFR >60 were 8. 2%, 9.2%, and 4.3% in group A, B, and C respectively (p < 0.0005). Incidence of CIN in patients with GFR = 30-60 were 19.1%, 4.5%, and 2.4% (p < 0.0005) and in patients with GFR < 30 were 34. 4%, 40.0%, and 25.9% (p = 0.510). Conclusions: Pre-hydration prophylaxis was effective in preventing CIN in mild renal impaired patients but are less so in more severely renal impaired patients (GFR < 30). STEMI patients undergoing primary PCI regardless of baseline GFR were at high risk. Accelerated prophylactic regime can be considered in this cohort. (J Interven Cardiol 2010;23:451-459)
International Journal of Medical and Biomedical Studies
Background: Contrast induced nephropathy remains important cause of hospital-acquired acute kidney injury and affects between 2% of the general population to 50% of high-risk subgroups following coronary intervention. Objectives: To determine the incidence and to study the various risk factors associated with CIN. Patients and Methods: In our study, total of 212 patients (154 males and 58 females) who received non ionic iso osmolar contrast media during percutaneous transluminal coronary intervention (PCI) were included. We diagnosed CIN by a relative increase of >25% or an absolute increase of >0.5 mg/dl in serum creatinine levels two days after procedure. Results: The incidence of CIN in our study was 15.1%. In univariate analysis: age >75 years, hypertention diabetes mellitus (DM), heart failure, hypotension, CKD [creatinine >1.5mg/dl] and increased contrast volume were associated with increased risk of CIN whereas, gender, anemia and use of IABP failed to reach st...
Saudi journal of kidney diseases and transplantation : an official publication of the Saudi Center for Organ Transplantation, Saudi Arabia, 2014
Contrast-induced nephropathy is the third most common cause of acute renal failure in hospitalized patients. The purpose of this study was to compare three supportive treatments for prevention of contrast-induced nephropathy in high-risk patients undergoing coronary angiography. In this randomized clinical trial study, 150 patients with at least one risk factor, such as, congestive heart failure, history of diabetes mellitus, age>65 years or renal failure were randomly assigned to three equal groups: First group (Sodium (Na) bicarbonate infusion), second group [(N-Acetylcysteine (NAC)+Sodium Chloride (Nacl)], third group (Nacl). Angiography was performed with 350 mgI/mL of Iohexol (Omnipaque). Serum creatinine (Cr), blood blood urea nitrogen (BUN), and urine pH were measured at the start of angiography and 48 hours later. The three groups had no significant difference in demographic characteristics or other risk factors before intervention (P>0.05). Forty eight hours after exp...