The female gender as a risk factor of contrast-induced acute kidney injury in patients with chronic coronary syndromes

Abstract

Background The female gender is a well known risk factor of acute kidney injury that is included in many score widely used by cardiologists for assessment of the risk of contrast-induced acute kidney injury (CI-AKI). The exact influence of gender in patients with chronic coronary syndromes requiring intraarterial contrast media administration remains to be established. Purpose The aim of our study was to assess the influence of gender on the risk of the development of CI-AKI in patients with chronic coronary syndromes, receiving optimal medical treatment and with indications for percutaneous coronary interventions (PCI). Methods 1023 patients with chronic coronary syndromes and indications to PCI were included in the prospective cohort clinical study. The CI-AKI was defined as a rise in serum creatinine equal to or more than 25% from baseline. Preventive measures included the administration of 0,9% saline with intravenous infusion speed of 1 ml/kg/h (0,5 ml/kg/h for patients with heart failure) before and after the procedure. The contrast media used were either iodixanol or iopromide, which are both known to cause less adverse events than high-osmolar contrast media. Results The CI-AKI developed in 132 patients (12,9%). The number of male patients was higher than the female ones (741 and 282, 72,4% and 27,6% respectively). The 95% confidence interval of the means was −0,004 to 0,0088. The F test was performed to compare variances: F was 1,297, DFn 281, Dfd 740, the p value was statistically significant. The CI-AKI developed in 45 females (16% of all the female patients) and 87 males (11,7% of all the male patients). Female patients were more likely to be enrolled in the study in older age (presented in population pyramid). This fact is likely to be due to the menopause and natural history of chronic coronary syndromes in female gender. Conclusion The female gender is a significant risk factor of the CI-AKI development in patients with chronic coronary syndromes undergoing percutaneous interventions. Women need to be screened and monitored more closely before any contrast media administration in catheterisation laboratory. FUNDunding Acknowledgement Type of funding sources: Public hospital(s). Main funding source(s): Sechenov University