Impact of Female Gender on Frequency of Contrast Medium-Induced Nephropathy: <i>Post Hoc</i> Analysis of Dialysis Versus Diuresis Trial

Kiski, D.; Stepper, Wibke; Breithardt, Günter; Reinecke, Holger

doi:10.1089/jwh.2009.1821

Cited by 14 publications

(12 citation statements)

References 27 publications

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“…This may be because of the higher ratio of diabetics (53%) in this study and it also indicates that diabetes not per se but when associated with microangiopathy is a bad prognostic factor for CIN. Unlike other studies, we found that older age 13,18 or female gender 16,19 are not independent predictors for CIN, this may be due to the under representation of these subgroups in this study (age >70 years À13% and female gender e 16.4%). This is not uncommon in the Indian context where elderly or females receive fewer coronary interventions 20 and those who do receive usually belong to the higher economic strata and hence may represent lower risk peer group.…”

Section: Discussioncontrasting

confidence: 99%

Risk Scoring System to Predict Contrast Induced Nephropathy Following Percutaneous Coronary Intervention

Victor¹,

Gnanaraj²,

Kumar³

et al. 2013

The American Journal of Cardiology

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Section: Discussioncontrasting

confidence: 99%

Risk Scoring System to Predict Contrast Induced Nephropathy Following Percutaneous Coronary Intervention

Victor¹,

Gnanaraj²,

Kumar³

et al. 2013

The American Journal of Cardiology

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“…Compared with men, women have increased cardiovascular mortality, especially after menopause (14). Specifically, in-hospital mortality after coronary angiography is higher in women (15,16), although in these cohorts, women were older and had a greater burden of comorbidity than men (17)(18)(19). CIAKI may be a factor in the relatively detrimental hospital course observed in women, although the reason for the higher incidence of CIAKI in women is unknown.…”

Section: Discussionmentioning

confidence: 99%

Short-term rosuvastatin therapy prevents contrast-induced acute kidney injury in female patients with diabetes and chronic kidney disease: a subgroup analysis of the TRACK-D study

Li¹,

Li²,

Xu³

et al. 2016

J. Thorac. Dis.

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Background: Female patients are at higher risk of contrast-induced acute kidney injury (CIAKI) compared to males. In the multicenter, prospective, TRACK-D study, short-term rosuvastatin has proven effectively reduce CIAKI in patients with type 2 diabetes mellitus and stage 2-3 chronic kidney disease (CKD). This study aimed to explore the efficacy of rosuvastatin in the female TRACK-D population.Methods: This study was a gender-based analysis of 2,998 patients (1,044 females) enrolled in the TRACK-D study and were randomized to short-term (2 days before and 3 days after procedure) rosuvastatin therapy or standard of care. The primary outcome was the incidence of CIAKI and the secondary outcome was a composite of death, dialysis/hemofiltration or worsening heart failure at 30 days.Results: CIAKI incidence was comparable between male and female patients in the overall study population (2.5% vs. 3.4%, P=0.165) and in the rosuvastatin group (2.4% vs. 2.1%, P=0.72), while it was higher in females than in males in the control group (3.1% vs. 5.3%, P=0.04). Female gender was an independent risk factor of CIAKI [odds ratio (OR) =1.65; 95% confidence interval (CI), 1.03-2.63; P=0.036].Rosuvastatin treatment vs. control lowered CIAKI rate in females [2.1% vs. 5.3%; relative risk (RR) =0.39; 95% CI, 0.19-0.77; number needed to treat (NNT) =31], particularly among those with CKD stage 2 (1.2% vs. 4.1%, P=0.011). Secondary outcome incidence was similar for females in the rosuvastatin and control groups (3.7% vs. 4.9%, P=0.37). Conclusions: Compared to males, untreated females with diabetes mellitus and CKD had a higher risk of CIAKI, which can be reduced by short-term rosuvastatin treatment.

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“…Further studies have shown that women experience greater GFR decline after contrast exposure. 6,7,18,19 Kiski et al, 20 in a recent post hoc analysis of the Dialysis-versus-Diuresis trial, concluded that women were more likely than men to have CIN within 72 hours after CM application.…”

Section: Discussionmentioning

confidence: 99%

Impact of Sex on the Risk to Develop Contrast-Induced Nephropathy after Transcatheter Aortic Valve Implantation

Madershahian

Scherner

Rudolph

et al. 2014

Innovations�(Phila)

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Objective Contrast-induced nephropathy (CIN) is the third most common cause of acute renal failure and is associated with increased morbidity and in-hospital mortality. Some recent studies identified female sex as a risk factor of CIN. The aim of this study was to determine the relative impact of female sex on the development and clinical outcome of CIN in patients with preexisting renal impairment after transapical transcatheter aortic valve implantation (TAVI). Methods From February 2008 to February 2011, a total of 55 TAVI patients [82.4 (6.5) years] with preprocedural serum creatinine level of greater than 1.1 mg/dL were retrospectively investigated. The incidence of postprocedural CIN, lengths of intensive care unit and hospital stay, and short-term mortality among men and women were compared. Contrast-induced nephropathy was defined as a creatinine increase of greater than 0.5 mg/dL or greater than 25% from baseline within 3 days after contrast medium (CM) exposure. Results The women had significantly lower body surface area [1.8 (0.18) vs 1.95 (0.17) m2; P = 0.002), lower hemoglobin levels [11.5 (1.3) vs 12.7 (1.6) g/dL, P < 0.001], and lower estimated glomerular filtration rate [34.2 (9.7) vs 49.4 (12.3) mL/min per 1.73 m2, P = 0.002]. The amount of CM given was significantly higher in the women relative to body surface area [67.3 (42.5) vs 48.3 (16.6) mL/m2, P = 0.043]. The women received a higher number of blood cell transfusion units [4.4 (3.4) vs 2.1 (2.7) U, P = 0.006]. The frequency of CIN within 72 hours after CM exposure was significantly higher in the women (62.1% vs 26.9%, P = 0.009). A total of 31% of the women (n = 9) versus 7.7% of the men (n = 2) needed hemodialysis ( P = 0.031). Analysis of the postoperative morbidity in terms of length of intensive care unit and hospital stay revealed no significant difference between the two groups. Mortality results reached a significant difference at 60 days, with 31% (n = 9) mortality in the women compared with 7.7% (n = 2) in the men ( P = 0.031). Conclusions Women with preexisting renal impairment are at higher risk than men for CIN, with resultant higher early mortality after transapical TAVI.

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Impact of Female Gender on Frequency of Contrast Medium-Induced Nephropathy: Post Hoc Analysis of Dialysis Versus Diuresis Trial

Abstract: Women are significantly more likely than men to suffer from CIN. This higher rate of CIN was confounded by unfavorable comorbidities, as found by univariate and multivariate analyses.

Cited by 14 publications

References 27 publications

Risk Scoring System to Predict Contrast Induced Nephropathy Following Percutaneous Coronary Intervention

Risk Scoring System to Predict Contrast Induced Nephropathy Following Percutaneous Coronary Intervention

Short-term rosuvastatin therapy prevents contrast-induced acute kidney injury in female patients with diabetes and chronic kidney disease: a subgroup analysis of the TRACK-D study

Impact of Sex on the Risk to Develop Contrast-Induced Nephropathy after Transcatheter Aortic Valve Implantation

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