Epidemiology of contrast-induced nephropathy.
Decreasing levels of renal function act as a major adverse prognostic factor after contrast exposure with or without percutaneous coronary intervention. In chronic kidney disease, the most important risk factor for the development of contrast-induced nephropathy (CIN) is an estimated glomerular filtration rate </= 60 mL/min/1.73 m2. Additional risk factors include diabetes, proteinuria, volume depletion, heart failure, and intraprocedural events. Overall, CIN occurs in approximately 15% of radiocontrast procedures, with < 1% requiring dialysis. CIN is directly related to increases in hospitalization length, cost, and long-term morbidity. For those patients who require dialysis, a 30% in-hospital mortality rate and 80% 2-year mortality rate can be expected. CIN is predictable and presents an opportunity to utilize preventive strategies, given the increasing numbers of patients undergoing contrast procedures worldwide.
McCullough
Peter A
PA
Department of Medicine, Divisions of Cardiology, Nutrition, and Preventive Medicine, William Beaumont Hospital, Royal Oak, MI.
Sandberg
Keisha R
KR
D002908:Chronic Disease; D002986:Clinical Trials as Topic; D003287:Contrast Media / Q000009:adverse effects*; D003404:Creatinine / Q000032:analysis; D003956:Dialysis; D006801:Humans; D015994:Incidence; D007674:Kidney Diseases / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology* / Q000628:therapy; D012307:Risk Factors
D003287:Contrast Media; D003404:Creatinine