Definition contraste5/27/2023 This correlated with a reduced GFR at 72 hours in patients with AKI (42.88 versus 90.92, p < 0.0001). The average baseline creatinine was similar in both groups with an average about 1 mg/dL, however showed difference at 72 hours in the CIN group the mean was 1.87 (± 0.69) mg/dL, compared with 0.97 (± 0.29) in the group without CIN (p < 0.0001). On admission, 6 (60%) patients with AKI had anemia compared with 10 (16.6%) patients without AKI (p = 0.0089). ![]() Table I: Baseline demographic characteristics.Īmong the demographic variables, patients with decreased renal function, 30% had diabetes mellitus type 2, 60% had high arterial hypertension and 10% had congestive heart failure. Our hypothesis is that the incidence and the risk factors of CIN is equal than the literature. The objective of this study was to calculate the incidence of CIN and to describe the clinical and periprocedural risk factors for patients receiving contrast media and as a secondary objective was to compare mortality between patients who developed CIN and those who not. ![]() There is few evidence in the literature review that evaluates the incidence and the risk factors that are associated with contrast media use in patients with ischemic cardiomyopathy that underwent a diagnostic or therapeutic PCI. Furthermore, it has been found that not only decreased in the glomerular filtration rate predicts the appearance of contrast nephropathy proteinuria plus a decreased GFR increases the incidence. The leading predictor for CIN is a pre-existent kidney injury, which increases more than 20 folds the risk for developing CIN, when glomerular filtration rate (GFR) is < 45 mL/min/1.73 m2. ![]() Patients undergoing primary PCI for myocardial infarction got some extra risk factors to develop CIN (hemodynamic instability, severe transient hypotension, use of intra-aortic balloon counterpulsation, undergoing emergency procedures and arterial contrast administration). The presence of dehydration, anemia, congestive heart failure (New York Heart Association (NYHA) III-IV), age > 70 years, gout, the use of nephrotoxic and NSAID drugs, all these increase the risk for AKI. (11) - (13) Preexisting renal impairment and diabetes mellitus appears to be primary risk factors for CIN. (9) Less than one-third patients develop some degree of residual renal impairment, and renal replacement therapy is required in less than 1% of patients, with a slightly higher incidence in patients with underlying AKI raising the mortality up to 17%, compared with just 3.9% in patients who don't develop AKI. (9), (10)įigure 1: Contrast-induced nephropathy physiopathology.ĬIN is normally a transient process, with renal functions reverting to the baseline within 7-14 days of contrast administration. They also exacerbate renal vasoconstriction, particularly in the deeper portions of the outer medulla. They cause a direct cytotoxic effect on the renal proximal tubular cells, enhance cellular damage by reactive oxygen species, and increase resistance to renal blood flow. The pathophysiology of CIN ( Figure 1) is based on contrast media (CM) which act on distinct anatomic sites within the kidney and exert adverse effects via multiple mechanisms. (6) Even more, is also associated with excess mortality and longer hospital stay. (4) However, the incidence of CIN is less than 2% (5) although, in patients with chronic kidney disease (CKD) the incidence is more than 12%, as well as in patients who developed an acute coronary syndrome (ACS) and underwent an urgent percutaneous coronary intervention (PCI). ![]() (1) - (3)ĬIN is an important cause of acute kidney injury (AKI) in hospitalized patients being reported as the third most common cause of kidney injury in patients who underwent interventional radiologic procedures. Contrast-induced nephropathy (CIN) is defined as the impairment of renal function and is measured as either a 25% increase in serum creatinine (SCr) from baseline or 0.5 mg/dL increase in absolute value, within 48-72 hours of intravenous contrast administration.
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