A Novel Risk Assessment Model Using Urinary System Contrast Blush Grading to Predict Contrast-Induced Acute Kidney Injury in Low-Risk Profile Patients

Abstract

Contrast-induced acute kidney injury (CI-AKI) can occur after coronary interventions despite protective measures. We evaluated the effect of urinary system contrast blush grading for predicting post-procedure CI-AKI in 486 patients with chronic coronary artery disease. Patient characteristics and blood samples were collected. Urinary system contrast blush grade was recorded during the coronary angiography and interventions. Post-procedure third to fourth day blood samples were collected for diagnosis of CI-AKI. The median age of the patients was 61 years (53-70, interquartile range), and 194 (39.9%) participants were female. Contrast-induced acute kidney injury occurred in 78 (16%) patients. By comparing full and reduced models with the likelihood ratio test, it was observed that in the reduced model, factors such as age, diabetes mellitus, body weight–adapted contrast media (CM), hemoglobin, and urinary system blush were associated with CI-AKI presence. The probability of CI-AKI presence increased slightly from grade 0 to 1 blush, but it increased sharply grade from 1 to 2 blush. According to our results, an increase in body weight–adapted CM and urinary blush grading were the main predictors of CI-AKI. These findings suggest that when body weight–adapted CM ratio exceeds 3.5 mL/kg and urinary contrast blush reaches grade 2, the patients should be followed up more carefully for the development of CI-AKI.

Predictive value of creatine kinase MB for contrast-induced acute kidney injury among myocardial infarction patients

“…Several studies have indicated that worsened LVEF was a predictor of CI-AKI [ 23 – 26 ]. In accordance with the previous study [ 23 , 27 , 28 ], our study demonstrated that the age and basal creatinine were independently correlated with CI-AKI. Cinar T et al also indicated that the age, creatinine and ejection fraction score correlated with ST-elevation myocardial infarction-related cardiogenic shock [ 29 ].…”

Comparative analysis of four established risk scores for predicting contrast induced acute kidney injury after primary percutaneous coronary interventions

“…In the continuation of efforts to develop clinically reliable risk stratification modalities, Ösken A et al [26] evaluated the neutrophil-to-lymphocyte ratio as a significant predictor of CI-AKI after carotid artery stenting with the adjusted odds ratio of 1.39 to 2.63 for CI-AKI. Similarly, another study by Efe SC et al [27] reported the urinary system contrast blush grading (grade 2 or higher) as an important predictor of CI-AKI along with elevated (>3.5) weight-adopted contrast medium ratio.…”

Elevated Serum Uric Acid/Albumin Ratio as a Predictor of Post-Contrast Acute Kidney Injury After Percutaneous Coronary Intervention in Patients with ST-Segment Elevation Myocardial Infarction

“… 2 , 3 Owing to the complexity of the mechanisms, effective preventative or therapeutic measures for PC-AKI are still lacking. 4 , 5 Therefore, the ability to estimate the risk of developing PC-AKI after PCI in a patient with STEMI may have great clinical importance in reducing the incidence of PC-AKI.…”