Proteinuria and Reduced Estimated Glomerular Filtration Rate Are Independent Risk Factors for Contrast-Induced Nephropathy After Cardiac Catheterization

Saito, Yoshihiko; Watanabe, Makoto; 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:10.1253/circj.cj-14-1345

Cited by 27 publications

(18 citation statements)

References 33 publications

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“…CHF was more common (40%) in patients who developed CIN than those who did not (18%). While this finding was not statistically significant, it corroborates prior reports that CHF is a risk factor for CIN [33], though other studies have not shown this association [34]. The findings reported here suggest that GFR is the best clinical variable to help triage potential high-risk patients for development of CIN.…”

Section: Discussionsupporting

confidence: 84%

Predictors of Active Extravasation and Complications after Conventional Angiography for Acute Intraabdominal Bleeding

Haber

Charles

Erinjeri

et al. 2017

JCM

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Conventional angiography is used to evaluate and treat possible sources of intraabdominal bleeding, though it may cause complications such as contrast-induced nephropathy (CIN). The study’s purpose was to identify factors predicting active extravasation and complications during angiography for acute intraabdominal bleeding. All conventional angiograms for acute bleeding (January 2013–June 2015) were reviewed retrospectively, including 75 angiograms for intraabdominal bleeding in 70 patients. Demographics, comorbidities, vital signs, complications within one month, and change in hematocrit (ΔHct) and fluids and blood products administered over the 24 h prior to angiography were recorded. Of 75 exams, 20 (27%) demonstrated extravasation. ΔHct was the only independent predictor of extravasation (p = 0.017), with larger ΔHct (−17%) in patients with versus those without extravasation (–1%) (p = 0.01). CIN was the most common complication, occurring in 10 of 66 angiograms (15%). Glomerular filtration rate (GFR) was the only independent predictor (p = 0.03); 67% of patients with GFR < 30, 29% of patients with GFR 30–60, and 8% of patients with GFR > 60 developed CIN. For patients with intraabdominal bleeding, greater ΔHct decrease over 24 h before angiography predicts active extravasation. Pre-existing renal impairment predicts CIN. Patients with large hematocrit declines should be triaged for rapid angiography, though benefits can be weighed with the risk of renal impairment.

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Section: Discussionsupporting

confidence: 84%

Predictors of Active Extravasation and Complications after Conventional Angiography for Acute Intraabdominal Bleeding

Haber

Charles

Erinjeri

et al. 2017

JCM

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“…The CINC-J study, a Japanese prospective, multicenter registry observational cohort study, was conducted to evaluate the incidence of CIN stratified by renal function, as described previously [12]. Briefly, we enrolled patients who underwent cardiac catheterization for diagnostic purposes or elective and emergent percutaneous coronary intervention treatment at 27 institutions from November 2011 to September 2013.…”

Section: Patient Enrollmentmentioning

confidence: 99%

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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“…In 2010, a large cohort study with 920,985 adults reported that the risk of acute kidney injury increased substantially with the presence and severity of proteinuria (20). Subsequent studies implicated proteinuria as a risk factor of AKI after intra-arterial contrast administration in the settings of percutaneous coronary intervention and stroke intervention (21–23). Piskinpasa et al reported that PC-AKI was significantly higher when proteinuria exceeded 1 g/day (24).…”

Section: Discussionmentioning

confidence: 99%

Predictors and Outcomes of Postcontrast Acute Kidney Injury after Endovascular Renal Artery Intervention

Takahashi

Kallmes

Fleming

et al. 2017

Journal of Vascular and Interventional Radiology

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Purpose To determine the incidence, predictors and clinical outcomes of post-contrast acute kidney injury (PC-AKI) following renal artery stent placement for atherosclerotic renal artery stenosis. Materials and Methods This retrospective study reviewed 1,052 patients who underwent renal artery stent placement for atherosclerotic renal artery stenosis. In total, 437 patients with follow-up were included in this study. Mean age was 73.6 ± 8.3 years. Post-contrast acute kidney injury was defined as an absolute serum creatinine increase ≥0.3 mg/dL or percentage increase in serum creatinine ≥50% within 48 hours of intervention. Logistic regression analysis was performed to identify risk factors for PC-AKI. The cumulative proportion of patients who died or went on to hemodialysis was determined using Kaplan-Meier survival analysis. Results Mean follow-up was 71.1±68.4 months. Twenty-six patients (5.9%) developed PC-AKI. Patients who developed PC-AKI had significantly higher levels of baseline proteinuria compared to those who did not (Odds ratio 1.38; 95% CI 1.11–1.72; P=0.004). Prehydration, chronic kidney disease stage, baseline GFR, statin medications, contrast volume and iodine load were not associated with higher rates of PC-AKI. Dialysis-free survival and mortality rates were not significantly different between patients with and without PC-AKI (P=0.50 and P=0.17, respectively). Conclusion Elevated baseline proteinuria was the only predictor for PC-AKI in patients undergoing renal artery stent placement. Patients who developed PC-AKI were not at greater risk for hemodialysis or death.

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Proteinuria and Reduced Estimated Glomerular Filtration Rate Are Independent Risk Factors for Contrast-Induced Nephropathy After Cardiac Catheterization

Cited by 27 publications

References 33 publications

Predictors of Active Extravasation and Complications after Conventional Angiography for Acute Intraabdominal Bleeding

Predictors of Active Extravasation and Complications after Conventional Angiography for Acute Intraabdominal Bleeding

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

Predictors and Outcomes of Postcontrast Acute Kidney Injury after Endovascular Renal Artery Intervention

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