Low hematocrit predicts contrast-induced nephropathy after percutaneous coronary interventions

Nikolsky, Eugenia; Mehran, Roxana; Lasić, Zoran; Mintz, Gary S.; Lansky, Alexandra J.; Na, Yingbo; Pocock, Stuart J.; Negoita, Manuela; Moussa, Issam; Stone, Gregg W.; Moses, Jeffrey W.; Leon, Martin B.; Dangas, George

doi:10.1111/j.1523-1755.2005.67131.x

Cited by 188 publications

(164 citation statements)

References 23 publications

(22 reference statements)

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“…24 Nikolsky, et al found the incidence of CIN after percutaneous coronary intervention was 13.9%. 23 Shaheen found the incidence of CIN after coronary angiography and percutaneous coronary intervention was 10%. 9 McCullough, et al also stated that incidence of CIN can rise to 50% or more in patients with multiple risk markers.…”

Section: Discussionmentioning

confidence: 99%

“…12 But Nikolsky, et al found about half of the patients had unstable angina. 23 The volume of contrast administered (£ 150ml), in normal blood glucose group was 30% and high blood glucose group was 36% but >150ml of contrast was administered 70% in normal blood glucose group and 64% in high blood glucose group. The difference in receiving contrast volume between two groups was not statistically significant (P>0.05).The results are consistent with Shaheen.…”

Section: Discussionmentioning

confidence: 99%

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Impact of Blood Glucose Levels on Contrast Induced Nephropathy after Percutaneous Coronary Intervention in Patients not known to be Diabetic with Acute Coronary Syndrome.

et al. 2013

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Background: Contrast-Induced Nephropathy (CIN) is an iatrogenic disorder, resulting from exposure to contrast media. The association between pre-procedural blood glucose levels and CI-AKI risk (regardless of pre-existing diabetes) is unknown. The present study was conducted to evaluate the incidence of CI-AKI in patients with admission hyperglycemia in non-diabetic ACS patients. Methods: This is Prospective, observational study done in the department of Cardiology, National Institute of Cardiovascular Diseases (NICVD), Dhaka. Considering inclusion and exclusion criteria, 50 patients were non diabetic with ACS with normal blood glucose (d7.8 mmol/l or d140 mg/dl) in (Group I) and 50 patients were non diabetic with ACS with high blood glucose (>7.8 mmol/l or >140 mg/dl) undergoing percutaneous coronary intervention in (Group II). On admission random blood glucose was measured. Non- ionic low osmolar contrast agents (lopamidol) was used in all patients. Serum creatinine, serum electrolytes was measured and creatinine clearance rate was determined within 24 hours before PCI and day 1 and 2 after PCI. Results: The incidence of CIN was 24% in high blood glucose group and 4% in normal blood glucose group (p=0.004). It was also observed that gradual incremental increase in risk of CIN associated with higher admission blood glucose level. There was positive correlation between s. creatinine and admission blood glucose but it showed negative correlation between CCr and admission blood glucose after PCI in ACS patients not known to be diabetic. Conclusion: The present study reveals that index admission high blood glucose in acute coronary syndrome patients not known to be diabetic is associated with increased incidence of contrast induced nephropathy after percutaneous coronary intervention. Cardiovascular Journal Volume 6, No. 1, 2013, Page 23-30 DOI: http://dx.doi.org/10.3329/cardio.v6i1.16111

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Impact of Blood Glucose Levels on Contrast Induced Nephropathy after Percutaneous Coronary Intervention in Patients not known to be Diabetic with Acute Coronary Syndrome.

et al. 2013

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“…In a large registry of 6,773 consecutive patients treated with PCI, low baseline hematocrit was identified as an independent predictor of CIN by multivariate analysis [27]. CIN (increase of 25% or 0.5 mg/ dL over preprocedure serum creatinine, at 48 hr postprocedure) rates steadily increased with baseline hematocrit quintile decrements (from 10.3% in the highest quintile to 23.3% in the lowest quintile) (P for trend < 0.0001).…”

Section: Anemiamentioning

confidence: 99%

“…Given the high prevalence of diabetes in the general population and its ability to cause broad spectrum of cardiovascular diseases, which require radiological procedures for their diagnosis and treatment, diabetic patients represent a significant proportion of those undergoing contrast exposure. Risk of CIN is increased even in diabetics with preserved renal function [24,27]. Presence of other risk factors, such as renal insufficiency or proteinuria, in diabetics further increases the risk for CIN.…”

Section: Diabetes Mellitusmentioning

confidence: 99%

Contrast‐induced nephropathy

Pučelíková

Dangas

Mehran

2007

Cathet Cardio Intervent

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Contrast induced nephropathy (CIN) is an iatrogenic disorder, resulting from exposure to contrast media. Contrast-induced hemodynamic and direct cytotoxic effects on renal structures are highly evident in its pathogenesis, whereas other mechanisms are still poorly understood. CIN is typically defined as an increase in serum creatinine by either 0.5 mg/dl or by 25% from baseline within the first 2-3 days after contrast administration. Although rare in the general population, CIN has a high incidence in patients with an underlying renal disorder, in diabetics, and the elderly. The risk factors are synergistic in their ability to produce CIN. The best way to prevent CIN is to identify the patients at risk and to provide adequate peri-procedural hydration. The role of various drugs in prevention of CIN is still controversial and warrants future studies. Despite remaining uncertainty regarding the degree of nephrotoxicity produced by various contrast agents, in current practice non-ionic low-osmolar contrast media are preferred over the high-osmolar contrast media in patients with renal impairment.

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“…Many studies have demonstrated that pre-existing abnormal renal function is a risk factor for drug-induced nephrotoxicity 23 . As a result, in those patients with mildly decreased renal function, anticancer drugs, antineoplastic or supportive care, should be cautiously selected in order to administer drugs that are not or are less nephrotoxic.…”

Section: Linking Powered By Extylesmentioning

confidence: 99%

Prevalence of renal insufficiency in breast cancer patients and related pharmacological issues

Launay-Vacher

Gligorov

Tourneau

et al. 2008

Breast Cancer Res Treat

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1 ST PROPOSITIONThe Renal Insufficiency and Anticancer Medications (IRMA) study is a French national, observational study which demonstrated the high prevalence of abnormal renal function in a population of 4684 solid tumour patients. Among them, 50 to 60% had decreased renal function defined as CrCl below 90, and 80% were treated with anticancer drugs that either necessitated dosage adjustment in case of RI or were potentially nephrotoxic drugs. Since patients and drugs used differ depending on the type of tumour, the IRMA Study Group started analyses in different subgroups of patients. In the 1898 IRMA patients with breast cancer, the prevalence of RI was still very high in spite of a normal serum creatinine in almost all cases. Some anticancer drugs, as in particular some bisphosphonates, capecitabine and platinum salts, may be nephrotoxic and/or need dosage adjustment. However other important drugs in breast cancer do not require dose reduction, and do not present with potential nephrotoxicity (anthracyclines, taxanes, trastuzumab). Both issues seem to be slightly but significantly more important in patients with bone metastases as compared to patients with a non-metastatic disease.Linking powered by eXtyles ABSTRACT: 2 ND PROPOSITION BACKGROUND. The Renal Insufficiency and Anticancer Medications (IRMA) study was a French national observational study. The results from this study of nearly 5000 patients demonstrated the high prevalence of renal impairment in a population of patients with solid tumors with 50 to 60% presenting with a decreased renal function defined as CrCl below 90, and 80% being treated with anticancer drugs that either necessitated dosage adjustment in case of RI or were potentially nephrotoxic drugs. Here are presented the results on patients with breast cancer.METHODS. Every cancer patient who presented at oncology departments that participated in the study over at least 1 of 2 predefined periods during 2004 was included in the IRMA study. Data on patients with breast cancer were analyzed. Renal function was calculated using Cockcroft-Gault and abbreviated Modification of Diet in Renal Disease (aMDRD) formulae to estimate the prevalence of renal insufficiency (RI) according to the KDOQI-KDIGO definition of kidney disease. Anticancer drugs were studied with regard to their potential renal toxicity and need for dosage adjustment.RESULTS. Of the 1898 IRMA breast cancer patients, 1.6% had a SCr level >110 lmol/L. However, when they were assessed using Cockcroft-Gault and aMDRD formulae, 51.8% and 50.8% had abnormal renal function, respectively. Of the 3465 anticancer drug prescriptions, 53.2% required dose adjustments for RI or were drugs with no available data on their administration in patients with RI. Of the patients treated, 90.4% received at least 1 such drug, and 76.9% received potentially nephrotoxic drugs. CONCLUSIONS. In the 1898 IRMA patients with breast cancer, the prevalence of RI was still very high in spite of a normal serum creatinine in almost all cases. Some antica...

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Low hematocrit predicts contrast-induced nephropathy after percutaneous coronary interventions

Abstract: Lower hematocrit is an important risk factor for contrast-induced nephropathy. Whether correcting the hematocrit prepercutaneous coronary intervention might decrease the rates of contrast-induced nephropathy should be addressed in a prospectively designed trial.

Cited by 188 publications

References 23 publications

Impact of Blood Glucose Levels on Contrast Induced Nephropathy after Percutaneous Coronary Intervention in Patients not known to be Diabetic with Acute Coronary Syndrome.

Impact of Blood Glucose Levels on Contrast Induced Nephropathy after Percutaneous Coronary Intervention in Patients not known to be Diabetic with Acute Coronary Syndrome.

Contrast‐induced nephropathy

Prevalence of renal insufficiency in breast cancer patients and related pharmacological issues

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