Mehran contrast nephropathy risk score: Is it still useful 10 years later?

Abellás-Sequeiros, Rosa A.; Raposeiras‐Roubín, Sergio; Abu-Assi, Emad; González-Salvado, Violeta; Iglesias-Álvarez, Diego; Diéguez, Alfredo Redondo; González‐Ferreiro, Rocío; Ocaranza-Sánchez, Raymundo; Peña-Gil, Carlos; Garcı́a-Acuña, José Marı́a; González-Juanatey, José Ramón

doi:10.1016/j.jjcc.2015.05.007

Cited by 47 publications

(35 citation statements)

References 27 publications

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“…13) Numerous studies have described the risk factors for CIN, which primarily include an extended duration of DM, preexisting chronic kidney disease, old age, heart failure, hypertension, and hypotension. 11,14) Similarly, the present study confirmed that age > 75 years, male gender, hypertension, diabetes, baseline sCr and eGFR < 60 mL/minute, LVEF < 40%, as well as ACEI/ARB and diuretic use were significantly associated with CIN. In addition, we also showed that sklotho was negatively correlated with CIN, consistent with previous studies involving other kinds of AKI.…”

Section: Discussionsupporting

confidence: 84%

A Nomogram to Predict Contrast Induced Nephropathy in Patients Undergoing Percutaneous Coronary Intervention

Zhuang

et al. 2017

Int. Heart J.

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SummaryContrast-induced nephropathy (CIN) is the third leading cause of hospital-acquired acute kidney injury (AKI). Emerging evidence has revealed that soluble klotho (sklotho) could be a novel biomarker for early AKI diagnosis. The aims of this study were to assess the predictive role of sklotho for CIN and to develop a prediction nomogram in patients undergoing percutaneous coronary intervention (PCI). This study is registered on Clinicaltrials.gov (NCT 02650336).Patients aged 18 years or older undergoing planned PCI were prospectively recruited between May 2014 and July 2015. CIN was defined as an increase in serum creatinine of 0.5 mg/dL within 48-72 hours after the procedure. Plasma sklotho was measured by enzyme linked immunosorbent assay (ELISA). Stratified analysis, interaction test, covariate screening, and curve fitting were performed to explore the association between sklotho and CIN. A nomogram was then developed and validated using the bootstrapped technique.A total of 192 patients aged 54.75 ± 12.19 years were selected, 32 (16.7%) of whom were diagnosed with CIN. A logistic regression model indicated significant associations between CIN and sklotho, age > 75 years, diabetes, and the Mehran risk score. Saturation effects analysis detected a two-stage change between sklotho and CIN, with the inflection point was 477.4 pg/mL. The area under the ROC curve was 0.758 and the sensitivity and specificity of this point were 90.6% and 53.9%, respectively. A nomogram was developed for the prediction of CIN and showed a bootstrapped-corrected area under the curve value of 0.913. In addition, sklotho significantly increased the predictive value of the nomogram.A strong association between sklotho and CIN was identified in patients undergoing elective PCI. A lower level of sklotho would be well correlated with CIN. The nomogram with sklotho is a useful tool to predict CIN in patients who will undergo PCI. (Int Heart J 2017; 58: 191-196)

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Section: Discussionsupporting

confidence: 84%

A Nomogram to Predict Contrast Induced Nephropathy in Patients Undergoing Percutaneous Coronary Intervention

Zhuang

et al. 2017

Int. Heart J.

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“…The Mehran risk score is currently the most widely used risk score for predicting the risk of CIN [3,18]. Although the population of the present study was different from those of Mehran's study, Values are represented as means AE SD, medians (interquartile range), or percentages.…”

Section: Discussionmentioning

confidence: 90%

Prediction of contrast-induced nephropathy by the serum creatinine level on the day following cardiac catheterization

Watanabe

Saito

Aonuma

et al. 2016

Journal of Cardiology

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“…It is crucial that patients at the highest risk for developing AKI be identified prior to PCI so that a risk reduction strategy may be employed. Mehran and colleagues developed a well‐validated and widely accepted risk score that could be readily applied by clinicians to evaluate individually predicted patient risk for developing AKI following PCI . Although previous data support the use of short‐term hemodynamic support with a pLVAD as an AKI risk reduction strategy during high‐risk PCI, validation specifically for Impella‐related renal protection and its clinical application for this purpose is lacking.…”

Section: Introductionmentioning

confidence: 99%

Impella support and acute kidney injury during high‐risk percutaneous coronary intervention: The Global cVAD Renal Protection Study

Flaherty¹,

Moses

Westenfeld

et al. 2019

Cathet Cardio Intervent

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Background: Protection against acute kidney injury (AKI) has been reported with the use of Impella during high-risk percutaneous coronary intervention (HR-PCI). We sought to evaluate this finding by determining the occurrence of AKI during Impellasupported HR-PCI in patients from the Global cVAD Study and compare this incidence with their calculated AKI risk at baseline. Methods and Results:In this prospective, multicenter study, we enrolled 314 consecutive patients. We included 223 patients that underwent nonemergent HR-PCI supported with Impella 2.5 or Impella CP and excluded those requiring hemodialysis prior to HR-PCI (19) and those with insufficient data (72). The primary outcome was AKI postprocedurally at 48 hr versus the predicted risk of AKI according to Mehran risk score. Logistic regression analysis determined predictors of AKI. Overall, 4.9% (11) of Impella-supported patients developed AKI (exclusively stage 1) at 48 hr versus a predicted rate of 21.9%, representing a 77.6% lower AKI rate (p < .0001). In this study, no Impella-supported patients required renal replacement therapy. Estimated glomerular filtration rate (ml/min/1.73 m 2 ) alone predicted AKI (adjusted odds ratio [AOR]: 4.915; 95% confidence intervals [CI]: 1.02-23.53, p = .046), and increasing contrast had insignificant effects on AKI during high-risk PCI (AOR: 1.15; 95% CI: 0.87-1.51, p = .332). In patients not protected from AKI, the postprocedure incidence of AKI was not significantly greater and did not correlate with chronic kidney disease severity.Conclusion: The incidence of AKI was lower during HR-PCI than expected from current risk models. Although further exploration of this finding is warranted, these data support a new protective strategy against AKI during HR-PCI.contrast, hemodynamic support, left ventricular dysfunction, renal protection ABBREVIATIONS: AKI, acute kidney injury; AKIN, acute kidney injury network; CIN, contrast-induced nephropathy; CKD, chronic kidney disease; Cr, creatinine; eGFR, estimated glomerular filtration rate; PCI, percutaneous coronary intervention; pLVAD, percutaneous left ventricular assist device.

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Mehran contrast nephropathy risk score: Is it still useful 10 years later?

Cited by 47 publications

References 27 publications

A Nomogram to Predict Contrast Induced Nephropathy in Patients Undergoing Percutaneous Coronary Intervention

A Nomogram to Predict Contrast Induced Nephropathy in Patients Undergoing Percutaneous Coronary Intervention

Prediction of contrast-induced nephropathy by the serum creatinine level on the day following cardiac catheterization

Impella support and acute kidney injury during high‐risk percutaneous coronary intervention: The Global cVAD Renal Protection Study

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