Literature DB >> 24680172

Lower blood vitamin D levels are associated with an increased incidence of contrast-induced nephropathy in patients undergoing coronary angiography.

Irfan Sahin1, Baris Gungor2, Mehmet Mustafa Can1, Ilhan Ilker Avci1, Gamze Babur Guler3, Ertugrul Okuyan1, Halil Biter1, Suleyman Sezai Yildiz1, Burak Ayca1, Seckin Satilmis4, Mustafa Hakan Dinckal1.   

Abstract

BACKGROUND: Vitamin D deficiency may be associated with an increased risk of renovascular disease. We assessed the correlation between vitamin D levels and contrast-induced nephropathy (CIN) in patients undergoing coronary angiography (CAG).
METHODS: Vitamin D and parathyroid hormone (PTH) levels were assessed before CAG in 403 patients. Estimated glomerular filtration rate (eGFR) was calculated using the Cockcroft-Gault equation. Patients with eGFR < 60 mL/min/1.73 m(2) were hydrated with 0.9%-saline at 1 mL/kg/h for 12 hours before and after CAG. CIN was defined as serum creatinine increase of > 0.5 mg/dL or > 25% within 48-72 hours after CAG.
RESULTS: CIN developed in 74 participants. Baseline eGFR, blood urea and creatinine in CIN (+) and (-) groups were not significantly different (P = 0.14, P = 0.07, and P = 0.61, respectively). Total volume of contrast medium (CM) was higher in the CIN (+) group (132 ± 64 mL vs 90 ± 41 mL; P = 0.01). Vitamin D levels were lower (median 8.5 [range, 0.5-26.6] ng/mL vs 14.9 [range, 1.9-93.5] ng/mL; P = 0.01) and PTH levels were higher (median 73.9 [range, 22-530] pg/mL vs 44.2 [range, 5-361] pg/mL; P = 0.01) in the CIN (+) group. Multivariate logistic regression analysis revealed that lower vitamin D levels (odds ratio [OR], 1.18; 95% confidence interval [CI], 1.11-1.26; P = 0.01) and increased CM volume (OR, 1.01; 95% CI, 1.008-1.017; P = 0.01) were independently correlated with CIN. In patients who had undergone percutaneous coronary intervention, lower levels of vitamin D were independently associated with CIN development.
CONCLUSIONS: Lower vitamin D levels, implying possible vitamin D deficiency, are associated with a higher incidence of CIN.
Copyright © 2014 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.

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Year:  2014        PMID: 24680172     DOI: 10.1016/j.cjca.2013.12.029

Source DB:  PubMed          Journal:  Can J Cardiol        ISSN: 0828-282X            Impact factor:   5.223


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