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RISK FACTORS FOR CONTRAST-INDUCED NEPHROPATHY AFTER CORONARY ANGIOGRAPHY

CARMEN DENISE CĂLDĂRARU^1*, DAN DOBREANU², MARIA DOGARU³, OVIDIU I. OLARIU⁴, GRIGORE DOGARU¹

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Contrast-induced nephropathy (CIN) has become a significant source of hospital morbidity and mortality with the increasing use of iodinated contrast media in interventional procedures. The current understanding of the disease suggests a multifactorial aetiology and many important issues unresolved about the pathogenesis and the prophylactic strategies. The purpose of this study was to determine risk factors for CIN pathogenesis after coronary angiography. We retrospectively studied patients undergoing cardiac catheterization from a cardiology clinic from January 2009 to June 2010. All hospitalized patients who had serum creatinine measured one day before and 48 and 72 hours after the procedure were included. Two subgroups were compared in terms of potential risk factors for contrast nephropathy: group A - patients with CIN and group B – patients without CIN. CIN was defined as an increase in serum creatinine by either ≥0.5 mg/dL or by ≥25% from baseline within the first 48 hours after contrast administration. We found no statistically significant differences between groups regarding gender, presence of hypertension or diabetes mellitus, cardiac ejection fraction, medical treatment before and after exposure, the type and the amount of contrast medium. In patients who developed CIN age was significantly higher (p= 0.01) and haemoglobin was lower (p= 0.0047). CIN was significantly associated with hypotension (p = 0.0015), loop diuretics use (p=0.04) and a low glomerular filtration rate (p=0.04). The reduction of glomerular filtration rate, loop diuretics use, anaemia, hypotension and older age were the main risk factors for contrast induced renal failure.