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

Watanabe, Makoto; Saito, Yoshihiko; Aonuma, Kazutaka; Hirayama, Atsushi; Tamaki, Nagara; Tsutsui, Hiroyuki; Murohara, Toyoaki; Ogawa, Hisao; Yoshimura, Michihiro; Sato, Akira; Takayama, Tadateru; Sakakibara, Mamoru; Suzuki, Susumu; Ishigami, Kousei; Onoue, Kenji

doi:10.1016/j.jjcc.2015.10.016

Cited by 10 publications

(7 citation statements)

References 20 publications

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“…A study of 860 patients with cardiac catheterization showed that change in eGFR ≤-1.1 mL/min/1.73 m 2 was a powerful independent predictor of CIN on the day following cardiac catheterization [16]. Our study found that eGFR was sensitive to early renal impairment in CHD patients.…”

Section: The Feasibility Study On the Diagnosis Of Cin By Egfr Desupporting

confidence: 50%

“…Diagnostic methods based on Scr have proved to be extremely limited. Scr and eGFR are both widely recognized indicators of renal function [16]. But Scr levels can be directly obtained by blood testing, while eGFR needs to be calculated by a complex formula; So eGFR is not as widely used as Scr.…”

Section: Discussion I the Value Of Scr And Egfr In Evaluating Early Rmentioning

confidence: 99%

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Feasibility of Using eGFR to Diagnose Contrast-Induced Nephropathy in Patients Undergoing Coronary Angiography

Gao¹,

Huang²,

Geng³

et al. 2020

JICOA

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Background: Contrast-induced nephropathy (CIN) is one of the common complications of coronary angiography (CAG). The changes of serum creatinine (Scr) before and after angiography were used to diagnose CIN in the world. But Scr is not a sensitive index to reflect early renal dysfunction. Estimated glomerular filtration rate (eGFR) is a comprehensive indicator to evaluate renal function but does not have accepted standard to diagnose CIN till now. This study aimed to investigate the feasibility of using eGFR to diagnose CIN in patients undergoing CAG. Methods: We included 300 coronary heart disease (CHD) patients who underwent CAG. Their demographics and basal renal function were recorded. Changes of Scr and eGFR before and after CAG were compared at the same time. Logistic regression was used to find independent influence factors of CIN. Receptor operating characteristic (ROC) curve was used to find the optimum cut-off value of eGFR for diagnosing CIN. Results: Among 300 patients with CHD, 64 (41 males and 23 females) of them were affected by CIN after CAG, with a total incidence of 21.3%. Among 271 patients whose Scr were normal (< 133 μmol/L) before CAG, 109 (40.2%) of them with impaired eGFR (< 90 ml/min/1.73m²). Patients had normal eGFR before CAG were less likely to develop CIN than those with normal Scr (15.4% vs 20.7%, P < 0.05). Logistic regression analysis showed that men, diabetes, multivessel lesion and eGFR were independent factors of CIN. ROC curve showed that the optimum cut-off value for diagnosing CIN was eGFR decrease by 22.5% after CAG (sensitivity = 98.4%, specificity = 98.3%, AUC = 0.973, 95%CI: 0.942-1.000, P = 0.000). Conclusions: eGFR is an independent factor of CIN, which is more sensitive than Scr in reflecting early renal dysfunction. Using eGFR to diagnose CIN is feasible in the clinic, but the cut-off value still needs to be confirmed by large scale clinical trials.

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Section: The Feasibility Study On the Diagnosis Of Cin By Egfr Desupporting

confidence: 50%

Section: Discussion I the Value Of Scr And Egfr In Evaluating Early Rmentioning

confidence: 99%

Feasibility of Using eGFR to Diagnose Contrast-Induced Nephropathy in Patients Undergoing Coronary Angiography

Gao¹,

Huang²,

Geng³

et al. 2020

JICOA

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“…Doppler evaluation 8 , 24-h serum creatinine elevation 9 , and renal injury biomarkers [10][11][12][13][14] . However, no predictive marker for long-term renal outcomes in patients undergoing CAG has been established.…”

mentioning

confidence: 99%

Increased circulating galectin-1 levels are associated with the progression of kidney function decline in patients undergoing coronary angiography

Kuo

Chou

et al. 2020

Sci Rep

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Galectin-1 modulates acute and chronic inflammation, and is associated with glucose homeostasis and chronic renal disease. Whether the serum galectin-1 level can predict short-term and longterm renal outcomes after contrast exposure in patients undergoing coronary angiography (CAG) remains uncertain. This study aimed to evaluate the relationship between the serum galectin-1 level and the incidence of contrast-induced nephropathy (CIN), and to investigate the predictive role of the circulating galectin-1 level for renal function decline in patients undergoing CAG. In total, 798 patients who had undergone CAG were enrolled. Baseline creatinine and serum galectin-1 levels were determined before CAG. CIN was defined as an increase in the serum creatinine level of 0.5 mg/dl or a 25% increase from baseline within 48 h after the procedure, and renal function decline was defined as > 30% reduction of the estimated glomerular filtration rate from baseline. All patients were followed for at least 1 year or until the occurrence of death after CAG. Overall, CIN occurred in 41 (5.1%) patients. During a median follow-up period of 1.4 ± 1.1 years, 80 (10.0%) cases showed subsequent renal function decline. After adjustment for demographic characteristics, kidney function, traditional risk factors, and medications, higher galectin-1 levels were found to be associated independently with a greater risk of renal function decline [tertile 2: hazard ratio (HR) 5.56, 95% confidence interval (CI) 1.79-17.22; tertile 3: HR 5.56, 95% CI 1.97-16.32], but not with CIN, regardless of the presence of diabetes. In conclusion, higher baseline serum galectin-1 levels were associated with a greater risk of renal function decline in patients undergoing CAG, but were not associated independently with CIN. Chronic kidney disease (CKD) is a serious public health problem, and its incidence and prevalence are increasing 1. The early detection of individuals at risk of CKD development or progression is especially important, as early-stage CKD is prevalent and contributes greatly to cardiovascular disease. Research clearly indicates that patients with coronary artery disease (CAD) are at increased risk of progressive renal dysfunction 2. These patients may be further exposed to the risk of contrast-induced nephropathy (CIN), which has an incidence rate of 4.4-22.1%, if they undergo coronary angiography (CAG) 3. CIN has traditionally been considered to be a benign and reversible disease, but it may prolong hospital stays and increase in-hospital mortality 4. Accumulating evidence suggests that CIN is related to long-term renal function decline, in addition to short-term outcomes 5,6. Efforts to predict the occurrence of CIN include the development of risk scoring systems composed of baseline risk factors 7 , renal

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“…Contrast-induced nephropathy (CIN) is defined as an increase in serum creatinine beyond 44.2 μmol/L (0.5 mg/dl) or 25% of the baseline within 72 h after contrast medium administration without other factors [1][2][3][4]. In recent years, more and more patients receive the therapy of percutaneous coronary intervention (PCI) [5].…”

Section: Introductionmentioning

confidence: 99%

The Role of Xuefu Zhuyu Decoction in Prevention of Contrast‐Induced Nephropathy after Percutaneous Coronary Intervention

Zhao

Liu

et al. 2020

Evidence-Based Complementary and Alternative Medicine

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Objective. This study aimed to investigate the effect of Xuefu Zhuyu decoction on preventing contrast-induced nephropathy (CIN) after percutaneous coronary intervention (PCI). Methods. A total of 256 patients undergoing selective PCI for coronary artery disease were consecutively enrolled and randomly divided into two groups: Group A (n = 126) and Group B (n = 130). Before and after PCI, all patients routinely received antiplatelet aggregation therapy, antilipidemic therapy, and hydration therapy. Besides routine therapy, patients in Group B received Xuefu Zhuyu decoction from 3 days before PCI to 3 days after PCI. Serum creatinine (Scr), estimated glomerular filtration rate (eGFR), superoxide dismutase (SOD), and malondialdehyde (MDA) were measured, respectively, at baseline (72 h before PCI) and at 24, 48, and 72 h after PCI. Results. Compared with Group A, Group B presented a lower fluctuation of SCr and eGFR (P<0.01). The incidence of CIN was less in Group B. According to the definition, CIN occurred in 5 patients (2.0%) in the intervention group and 5 (4.0%) in the control group (P=0.167). In terms of oxidative stress, Group B had a lower MDA (P<0.05), but a higher SOD (P<0.05). Conclusions. Compared with the control group, Xuefu Zhuyu decoction intervention therapy increased the level of SOD and reduced MDA. The Xuefu Zhuyu decoction intervention group presented a higher level of eGFR at 24, 48, and 72 h after PCI in patients with coronary heart disease and a lower level of Scr. The results are propitious to prove that Xuefu Zhuyu decoction might play an antioxidative stress role in the prevention of CIN after PCI.

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

Abstract: Changes in SCr and eGFR on the day following cardiac catheterization predict the development of CIN.

Cited by 10 publications

References 20 publications

Feasibility of Using eGFR to Diagnose Contrast-Induced Nephropathy in Patients Undergoing Coronary Angiography

Feasibility of Using eGFR to Diagnose Contrast-Induced Nephropathy in Patients Undergoing Coronary Angiography

Increased circulating galectin-1 levels are associated with the progression of kidney function decline in patients undergoing coronary angiography

The Role of Xuefu Zhuyu Decoction in Prevention of Contrast‐Induced Nephropathy after Percutaneous Coronary Intervention

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