BACKGROUND: The aim of this study was to investigate the incidence of contrast-induced nephropathy (CIN) according to renal function in patients with or without proteinuria after cardiac catheterization in Japan. METHODS AND RESULTS: We conducted a multicenter prospective observational study involving 27 hospitals from all over Japan, which enrolled 906 patients with cardiac catheterization. CIN was defined as increase in serum creatinine ≥0.5 mg/dl or ≥25% from baseline between 48 and 72 h after exposure to contrast. The incidence of CIN in patients with estimated glomerular filtration rate (eGFR) <30 ml/min/1.73 m<sup>2</sup>was significantly higher than that in patients with eGFR ≥60 ml/min/1.73 m<sup>2</sup>. In patients without proteinuria, the incidence of CIN did not increase as eGFR decreased, but such a trend was observed in patients with proteinuria. Proteinuria was highly significantly associated with CIN in patients with eGFR 30-44 ml/min/1.73 m<sup>2</sup>(OR, 12.1; 95% CI: 2.81-82.8; P=0.0006) and eGFR <30 ml/min/1.73 m<sup>2</sup>(OR, 17.4; 95% CI: 3.32-321; P=0.0001). On multivariate logistic regression analysis, proteinuria (OR, 4.09; 95% CI: 1.66-10.0), eGFR (OR, 1.02; 95% CI: 1.00-1.04), contrast volume/eGFR (OR, 1.31; 95% CI: 1.04-1.65), and Ca antagonist use (OR, 3.79; 95% CI: 1.52-10.8) were significant predictors of CIN. CONCLUSIONS: Proteinuria and reduced eGFR are independent risk factors for CIN after cardiac catheterization.
BACKGROUND: The aim of this study was to investigate the incidence of contrast-induced nephropathy (CIN) according to renal function in patients with or without proteinuria after cardiac catheterization in Japan. METHODS AND RESULTS: We conducted a multicenter prospective observational study involving 27 hospitals from all over Japan, which enrolled 906 patients with cardiac catheterization. CIN was defined as increase in serum creatinine ≥0.5 mg/dl or ≥25% from baseline between 48 and 72 h after exposure to contrast. The incidence of CIN in patients with estimated glomerular filtration rate (eGFR) <30 ml/min/1.73 m<sup>2</sup>was significantly higher than that in patients with eGFR ≥60 ml/min/1.73 m<sup>2</sup>. In patients without proteinuria, the incidence of CIN did not increase as eGFR decreased, but such a trend was observed in patients with proteinuria. Proteinuria was highly significantly associated with CIN in patients with eGFR 30-44 ml/min/1.73 m<sup>2</sup>(OR, 12.1; 95% CI: 2.81-82.8; P=0.0006) and eGFR <30 ml/min/1.73 m<sup>2</sup>(OR, 17.4; 95% CI: 3.32-321; P=0.0001). On multivariate logistic regression analysis, proteinuria (OR, 4.09; 95% CI: 1.66-10.0), eGFR (OR, 1.02; 95% CI: 1.00-1.04), contrast volume/eGFR (OR, 1.31; 95% CI: 1.04-1.65), and Ca antagonist use (OR, 3.79; 95% CI: 1.52-10.8) were significant predictors of CIN. CONCLUSIONS:Proteinuria and reduced eGFR are independent risk factors for CIN after cardiac catheterization.
Authors: Edwin A Takahashi; David F Kallmes; Chad J Fleming; Robert J McDonald; Michael A McKusick; Haraldur Bjarnason; William S Harmsen; Sanjay Misra Journal: J Vasc Interv Radiol Date: 2017-09-22 Impact factor: 3.464
Authors: J Latus; V Schwenger; G Schlieper; H Reinecke; J Hoyer; P B Persson; B A Remppis; F Mahfoud Journal: Internist (Berl) Date: 2020-12-21 Impact factor: 0.743
Authors: Sandeep Brar; Kathleen D Liu; Alan S Go; Raymond K Hsu; Vernon M Chinchilli; Steven G Coca; Amit X Garg; Jonathan Himmelfarb; T Alp Ikizler; James Kaufman; Paul L Kimmel; Chirag R Parikh; Edward D Siew; Lorraine B Ware; Hui Zeng; Chi-Yuan Hsu Journal: Clin J Am Soc Nephrol Date: 2020-12-03 Impact factor: 8.237