Yub Raj Sedhai1, Reshma Golamari2, Santosh Timalsina3, Soney Basnyat4, Ajay Koirala5, Ankush Asija6, Tatvam Choksi7, Akanksha Kushwah8, David Geovorgyan2, Tawseef Dar2, Madhura Borikar2, Waseem Ahangar2, Joseph Alukal2, Subtain Zia9, Jose Missri2. 1. Department of Internal Medicine, Mercy Catholic Medical Center, Darby, Pennsylvania. Electronic address: dr.sedhai@gmail.com. 2. Department of Internal Medicine, Mercy Catholic Medical Center, Darby, Pennsylvania. 3. Department of Biochemistry, Chitwan Medical College, Bharatpur, Chitwan, Nepal. 4. Department of Internal Medicine, St Mary Mercy Hospital, Livonia, Michigan. 5. Department of Internal Medicine, Reading Health System, Reading, Pennsylvania. 6. VCU Community Memorial Hospital, South Hill, Virginia. 7. Department of Medicine, University of Chicago, Chicago, Illinois; Department Internal Medicine, University of Chicago, Chicago, Illinois. 8. Department of Pathology, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal; Department of Pathology, Tribhuvan University Teaching Hospital, Nepal. 9. Philadelphia College of Osteopathic Medicine, Philadelphia, Pennsylvania; Department of Osteopathic Medicine, Philadelphia College of Osteopathic Medicine, Philadelphia, Pennsylvania.
Abstract
BACKGROUND: Contrast-induced nephropathy (CIN) is a common complication after radiocontrast exposure. METHODS: A retrospective medical record review of 513 hospitalized patients who underwent cardiac catheterization from June-December 2014 was done, of which 38 patients with end-stage renal disease and 57 patients without preprocedural creatinine were excluded. Serum creatinine concentration before the procedure and each day for 3 days after the procedure was recorded. CIN was defined as an increase in serum creatinine concentration by ≥25% or ≥0.5mg/dL from the preprocedural value within 72hours of contrast exposure. RESULTS: A total of 418 patients (mean age: 69.1 ± 13.8 years, 55% males) were included in the study. Mean incidence of CIN was 3.7% (n = 16). CIN accounted for longer duration of hospitalization, lengthier intensive care unit admission, requirement of hemodialysis and higher mortality. Incidence of CIN was higher in the presence of preexisting atrial fibrillation (AF), congestive heart failure (CHF) and chronic kidney disease (CKD). When tested by univariate analysis, incidence of CIN was 13.8% in the AF group (P < 0.001), 8.6% in CHF group (P < 0.01) and 8.9% in CKD group (P < 0.002), compared with 2.3%, 1.9% and 2.4% in the absence of preexisting AF, CHF and CKD, respectively. On further testing using multivariate logistic regression model using AF, CHF and CKD as independent variables, development of CIN was strongly associated with preexisting AF with an odds ratio of 4.11, 95% CI: 1.40-12.07, P = 0.01. CONCLUSION: Identifying patients at risk is an important step in preventing CIN. Preexisting AF, independent of traditional risk factors, may increase the risk for CIN.
BACKGROUND: Contrast-induced nephropathy (CIN) is a common complication after radiocontrast exposure. METHODS: A retrospective medical record review of 513 hospitalized patients who underwent cardiac catheterization from June-December 2014 was done, of which 38 patients with end-stage renal disease and 57 patients without preprocedural creatinine were excluded. Serum creatinine concentration before the procedure and each day for 3 days after the procedure was recorded. CIN was defined as an increase in serum creatinine concentration by ≥25% or ≥0.5mg/dL from the preprocedural value within 72hours of contrast exposure. RESULTS: A total of 418 patients (mean age: 69.1 ± 13.8 years, 55% males) were included in the study. Mean incidence of CIN was 3.7% (n = 16). CIN accounted for longer duration of hospitalization, lengthier intensive care unit admission, requirement of hemodialysis and higher mortality. Incidence of CIN was higher in the presence of preexisting atrial fibrillation (AF), congestive heart failure (CHF) and chronic kidney disease (CKD). When tested by univariate analysis, incidence of CIN was 13.8% in the AF group (P < 0.001), 8.6% in CHF group (P < 0.01) and 8.9% in CKD group (P < 0.002), compared with 2.3%, 1.9% and 2.4% in the absence of preexisting AF, CHF and CKD, respectively. On further testing using multivariate logistic regression model using AF, CHF and CKD as independent variables, development of CIN was strongly associated with preexisting AF with an odds ratio of 4.11, 95% CI: 1.40-12.07, P = 0.01. CONCLUSION: Identifying patients at risk is an important step in preventing CIN. Preexisting AF, independent of traditional risk factors, may increase the risk for CIN.
Authors: Nathan Wong; Diem T Dinh; Angela Brennan; Riley Batchelor; Stephen J Duffy; James A Shaw; William Chan; Jamie Layland; William J van Gaal; Christopher M Reid; Danny Liew; Dion Stub Journal: Open Heart Date: 2022-10
Authors: Daniele Melo Sardinha; Alzinei Simor; Letícia Diogo de Oliveira Moura; Ana Gracinda Ignácio da Silva; Karla Valéria Batista Lima; Juliana Conceição Dias Garcez; Lidiane Assunção de Vasconcelos; Anderson Lineu Siqueira Dos Santos; Luana Nepomuceno Gondin Costa Lima Journal: Int J Environ Res Public Health Date: 2020-05-13 Impact factor: 3.390
Authors: Eve Vilaine; Paul Gabarre; Alain Beauchet; Alexandre Seidowsky; Olivier Auzel; Marie Hauguel-Moreau; Olivier Dubourg; Nicolas Mansencal; Marie Essig; Ziad A Massy Journal: Cardiol Cardiovasc Med Date: 2021-12-03