Full Blood Count as a Potential Predicting Factor of Contrast-Induced Nephropathy After Endovascular Aortic Aneurysm Repair

Abstract

Contrast-induced nephropathy (CIN) is an important adverse effect of administration of intravenous contrast agent (CA) associated with prolonged hospitalization as well as increased cardiovascular and renal morbidity and all-cause mortality. 1 Several risk factors can predict CIN incidence, and various scores have been proposed to identify high-risk patients prior to CA exposure. 1 Endovascular aortic aneurysm repair (EVAR) requires CA for the preinterventional computed tomography (CT), during the procedure and the follow-up period when using CT. 2 Clinical assessment of kidney function is a routine practice pre-EVAR because the incidence of acute kidney injury after EVAR is significant and is independently associated with medium-term mortality and morbidity. 3,4 The complete blood count, a readily available, routine examination, has been considered as an indicator of CIN in cardiology patients. [5][6][7] The neutrophil to lymphocyte ratio, 5 platelet to lymphocyte ratio, 6 and red cell distribution width 7 have been suggested as predictors of CIN in patients undergoing cardiologic interventional procedure. Considering the common pathway between pathophysiology and risk profiles in coronary artery disease and abdominal aortic aneurysm, 8 we suggest that a complete blood count could be used to identify patients who are at high risk of CIN after EVAR.Future prospective studies should assess the potential usefulness of the complete blood count in the identification of patients at high risk to develop post-EVAR CIN. This may guide the need for intense preprocedural preventive strategy.

Incidence of Contrast-Induced Nephropathy and Post-Operative Outcomes in Patients Undergoing Chimney Endovascular Aortic Aneurysm Repair

“…[24][25][26][36][37][38][39][40] In addition, several studies have pointed to their interest as predictors of CI-AKI in patients undergoing cardiac procedures 41,42 or in patients undergoing diagnostic angiography for peripheral artery disease or carotid stenosis. 12,13 It has been hypothesized that pre-operative NLR and PLR could also serve as a predictive factor in patients undergoing AAA repair, 43 and our study corroborates that for the first time. Interestingly, another study including 230 patients who underwent EVAR also showed that post-operative NLR and PLR values were associated with the occurrence of AKI, with respectively a sensitivity of 80% and specificity of 81% for the NLR, and 80% and 83% for the PLR.…”

Bilirubin Levels are Associated With Contrast-Induced Nephropathy in Peripheral Artery Disease

“…4,5 In previous studies, uric acid, red cell distribution width (RDW), platelet-to-lymphocyte ratio, and neutrophil-to-lymphocyte ratio (NLR) were found to be associated with CIN. [6][7][8][9] Bilirubin has been reported to have strong antioxidant and cytoprotective properties, which have been linked to its role as an efficient scavenger of reactive oxygen radicals. 10 Bilirubin also exerts anti-inflammatory effects on the vasculature.…”

“…4,5 In previous studies, uric acid, red cell distribution width (RDW), platelet-to-lymphocyte ratio, and neutrophil-to-lymphocyte ratio (NLR) were found to be associated with CIN. 6 –9…”

A Molécula de Lesão Renal-1 está Associada à Nefropatia Induzida por Contraste em Pacientes Idosos com IAMSSST

“…3,4 O ácido úrico, a largura de distribuição dos glóbulos vermelhos, a proporção de plaquetas para linfócitos e a proporção de neutrófilos para linfócitos foram correlacionados com a NIC em estudos prévios. 5,6 A molécula de lesão renal-1 (KIM-1) tem sido relacionada à ocorrência e à gravidade da lesão renal aguda e da doença renal crônica. 7 A KIM-1 é uma proteína transmembrana do tipo 1, expressa de acordo com a lesão no túbulo proximal da membrana apical.…”