Predicting angiography-induced acute renal function impairment: clinical risk model.

Two hundred sixty-six patients were evaluated for development of acute renal function impairment after renal angiography. Forty-five (16.9%) had a significant increase in serum level of creatinine (sCr), six developed oliguria or anuria, and one required permanent dialysis. Age, proteinuria, abnormal baseline sCr, use of Renografin 76, and preexisting renal disease were the five independent risk factors in the series. An odds-ratio analysis establishes the relative risk (i.e., likelihood) of developing acute renal insufficiency when a given risk factor is present. For example, patients with underlying renal disease were 6.6 times more likely to develop a transient increase in sCr than those with no renal disease. A clinical test model was devised to predict the likelihood that a given individual would develop acute renal insufficiency after renal angiography on the basis of the number of risk factors present. An increasing relation was demonstrated; the more factors present, the more likely it becomes that a patient will develop acute renal insufficiency.