A simple risk score for prediction of contrast-induced nephropathy after percutaneous coronary intervention

Abstract

The risk of CIN after PCI can be simply assessed using readily available information. This risk score can be used for both clinical and investigational purposes.

The effect of radiological contrast media on renal function and inflammatory markers in people with diabetes – a clinical study and review

“…[15][16][17] Elevated CRP prior to exposure to CM is a significant and independent predictor of CIN; inflammation is a pro-thrombotic state and elevated levels of inflammatory markers may contribute to increased plasma viscosity and subsequent tubular damage. 10,11 Consequences of administration of contrast medium Our study supports previous findings that people with co-existing diabetes and renal dysfunction are at increased risk of CIN 7,18,19 : all five of our patients who developed CIN had pre-existing CKD. The risk of CIN has been shown to be related to the severity of pre-existing CKD, 20,21 but the exact relationship and the point at which damage is most likely to occur has yet to be determined.…”

“…Its pathogenesis is poorly understood, but is thought to be mediated in part by changes in renal haemodynamics and alterations in the balance of renal vascular vasodilators and vasoconstrictors, leading to reduced blood flow. 6 Diabetes is one of a number of independent risk factors for developing CIN (along with hypotension, use of an intra-aortic balloon pump, heart failure, advanced age, high serum creatinine, anaemia, chronic kidney disease (CKD) and administration of a large volume of CM), 7 and evidence is emerging for a role of the inflammatory marker C-reactive protein (CRP). [8][9][10][11] CRP has been implicated in preventing vasodilation by increasing the activity of inhibitors of nitric oxide synthase and is widely recognised as a non-specific marker for systemic inflammation.…”

Blood Transfusion and the Risk of Acute Kidney Injury Among Patients With Acute Coronary Syndrome Undergoing Percutaneous Coronary Intervention

“…Transfusion is relatively commonly used in these patients, and there is considerable variation in blood transfusion practices among patients undergoing PCI at the US hospitals. 8 The appropriate use of transfusion in this patient population might be influenced by its effect on AKI.Anemia is well-recognized as a risk factor for AKI, 9 and recently periprocedural bleeding in PCI patients was also identified to be associated with AKI. 10 However, the relationship between anemia, bleeding, and transfusion and the risk of AKI has not been well studied.…”

“…Anemia is well-recognized as a risk factor for AKI, 9 and recently periprocedural bleeding in PCI patients was also identified to be associated with AKI. 10 However, the relationship between anemia, bleeding, and transfusion and the risk of AKI has not been well studied.…”

Contrast-Induced Sustained Kidney Injury

“…4,10,11 But, this is confounded by the known risk factors for CI-AKI: look at a risk score for developing CI-AKI and you will find a list of factors associated with worse cardiovascular outcomes. 12,13 Thus, the identification of serum NGAL ≥179 ng/mL 6 hours after contrast exposure is associated with a 2.5-fold increased risk of 1-year major adverse events in multivariable logistic regression models in this study. But there is a missing piece of evidence that patients need: if we blunt the rise of NGAL in these high risk patients, do they get fewer major adverse events in follow-up?…”