140 Incidence and Risk Factors for Contrast Induced Nephropathy in Patients Undergoing Percutaneous Coronary Intervention at a Tertiary Centre

Abstract

, 24 patients fulfilled the inclusion criteria and were recruited for this study. The age of first systemic lupus erythromatosus (SLE) ranged from 15 years to 69 years while the mean age at time of TPE treatment was 30.1AE12.9 yrs. Majority were of Malay race (83.3%) followed by the Chinese (12.5%) while 79.2% were female. Other than the AKI, the indications for TPE were cresenteric glomerulonephitis (57%), thrombotic microangiopathy (22%), thrombotic thrombocytopenic purpura (10%), and pulmonary hemorrhage (11%). Majority of the AKI were severe with 20 patients (83.3%) requiring dialysis support. 22 of the patients had underwent renal biopsy with 73% of the patients having lupus nephritis class IV while 11.5% had lupus nephritis class III. Twenty patients underwent DFPP, 1 patients underwent standard plasma exchange, while 3 patients had both DFPP and plasma exchange. The mean plasma volume exchanged was 2.5 AE0.79L. There was marked improvement in renal outcome with 9 patients (34.6%) having complete renal recovery, 8 patients (30.4%) developed chronic kidney disease, and only 3 patients (12%) remained dialysis dependent. Seven patients (30.8%) died while 1 patient was lost to follow up. Conclusion: The use of therapeutic plasmapharesis in patients with severe lupus nephritis and AKI is very encouraging. A prospective randomized controlled study should be conducted to confirm the efficacy and the benefit of TPE in this subgroup of severe lupus nephritis.