Risk Factors for Contrast-related Acute Kidney Injury According to Risk, Injury, Failure, Loss, and End-stage Criteria in Patients With Coronary Interventions

Authors

  • Maryam Pakfetrat Department of Nephrology, Nephro-Urology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
  • Mohammad Hossein Nikoo Interventional Electro-Physiology, Fars Heart Foundation
  • Leila Malekmakan Department of Nephrology, Nephro-Urology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
  • Mahmood Tabande Department of Cardiovascular, Fars Heart Foundation, Kowsar Hospital, Shiraz, Iran
  • Jamshid Roozbeh Department of Nephrology, Nephro-Urology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
  • Ganbarali Reisjalali Department of Cardiology, Shiraz University of Medical Sciences, Shiraz, Iran
  • Najaf Zare Department of Biostatistics, Faculty of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
  • Parviz Khajedehi Department of Nephrology, Nephro-Urology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran

Abstract

Introduction. Although a series of risk factors for contrast-induced nephropathy are known, data on significance of some of the risk factors such as age, sex, hypercholesterolemia, hyperuricemia, and dose of contrast medium are inconsistent. Our aim was to identify risk factors for contrast-related acute kidney injury (AKI).

Materials and Methods. In this prospective study, 290 consecutive patients with a serum creatinine level lower than 3 mg/dL undergoing percutaneous angiography were analyzed. Contrast-related AKI was evaluated using the risk, injury, failure, loss, and end-stage (RIFLE) criteria, and its correlation with clinical and laboratory data of the patients was analyzed.

Results. Contrast-related AKI was found in 15.5% of the patients, with a maximum RIFLE category (risk in 13.8%, injury in 1.4%, and failure in 0.3%). Serum creatinine level, contrast volume, safe contrast volume factor, diabetes mellitus, and dehydration were significantly associated with contrast-related AKI. Age, sex, and serum uric acid level did not differ significantly between those with and without contrast-related AKI. Multiple logistic regression analysis disclosed diabetes mellitus to be the strongest predictor for being at risk of contrast-related AKI (odds ratio, 5.1; 95% confidence interval, 1.9 to 11.0; P = .001), followed by hypercholesterolemia (odds ratio, 4.6; 95% confidence interval, 1.1 to 8.3; P = .03), and an estimated glomerular filtration rate lower than 90 mL/min/1.73 m2 (odds ratio, 3.0; 95% confidence interval, 1.8 to 5.7; P = .003).

Conclusions. Our results indicate that diabetes mellitus, hypercholesterolemia, and underlying chronic kidney disease are the major factors of contrast-related AKI.

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Published

2010-04-19

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Section

ORIGINAL | Kidney Diseases