Contrast-Induced Nephropathy Among Patients Undergoing Cardiac Catheterization

Abstract

Contrast-induced nephropathy is an important complication after cardiac catheterization, and is associated with accelerated renal disease, increased costs, mortality rate, need for dialysis and prolonged hospital stay. This study aim is to find its incidence and risk factors. It is a cross-sectional study on 160 patients admitted for diagnostic or therapeutic percutaneous coronary intervention in Basra Cardiac Center, from March to September 2016. Data collected were a complete history, examination, blood pressure, Echo study, fasting blood sugar, lipid profile, blood urea, serum creatinine and estimated glomerular filtration rate, the type and duration of procedure, volume of contrast, and after 48 hours renal function tests were repeated. Contrast-induced nephropathy has developed in 7 (8.3%) men and 5 (6.6%) women; 11 (10.8%) from 102 patients with dyslipidemia (P = 0.03); 8 (22.2%) from 36 with preexisting renal impairment (P = 0.01); 11 (10.9%) from 101 with hypertension (P = 0.02); 9 (13.6%) from 66 diabetic (P = 0.016); 9 (17.3%) from 52 smoker (P = 0.002); 4 (23.5%) from 17 alcohol drinkers (P = 0.026); 11 (11.2%) from 98 with ischemic heart disease (P = 0.02); and 9 (25.7%) from 35 with heart failure (P = <0.001). Also found in 1 (1.6%) from 64 diagnostic procedures; 11 (11.5%) from 96 therapeutic procedures (P = 0.016); 5 (3.7%) from 135 patients received < 300 ml of contrast; and 7 (28%) from 25 received ≥ 300 ml (P = 0.001). In conclusion contrast-induced nephropathy is aggravated by increasing age, diabetes mellitus, heart failure, ischemic heart disease, renal impairment, hypertension, dyslipidemia, smoking and alcohol use. The type of procedure (therapeutic vs. diagnostic), and large volume of contrast agent are important risk factors. Gender had no significant effect.