title: Angiotensin-converting enzyme inhibitors as a risk factor for contrast-induced nephropathy.
abstract: OBJECTIVE
  The aim of the present study was to assess the influence of chronic angiotensin-converting enzyme (ACE) inhibitor administration on the development of contrast-induced nephropathy (CIN) in patients undergoing coronary angiography.
  
  
  METHODS
  A total of 230 patients with renal insufficiency and age > or =65 years were divided into two groups according to prior use of ACE inhibitors (ACE inhibitor group, n = 109; control group, n = 121). CIN was defined as an increase of > or =25% in creatinine over the baseline value within 48 h of angiography.
  
  
  RESULTS
  CIN occurred in 17 patients (15.6%) in the ACE inhibitor group and 7 patients (5.8%) in the control group (p = 0.015). Serum creatinine level increased from 1.34 +/- 0.20 to 1.53 +/- 0.27 mg/dl in the ACE inhibitor group and from 1.33 +/- 0.18 to 1.45 +/- 0.19 mg/dl in the control group (p < 0.001). Chronic ACE inhibitor administration was a risk indicator of CIN [odds ratio 3.37; 95% confidence interval 1.14-9.94; p = 0.028]. Multi-vessel coronary involvement (p = 0.001), hypoalbuminemia (p = 0.005), diabetes mellitus (p = 0.006), GFR < or =40 ml/min (p = 0.010), and congestive heart failure (p = 0.024) were other risk indicators of CIN.
  
  
  CONCLUSIONS
  Chronic ACE inhibitor administration is a risk for developing CIN in elderly patients with renal insufficiency.
authors: Department of Nephrology, Ataturk Training and Research Hospital, Izmir, Turkey.
authors: Mustafa
authors: M
authors: Cirit
authors: Omer
authors: O
authors: Toprak
authors: Murat
authors: M
authors: Yesil
authors: Serdar
authors: S
authors: Bayata
authors: Nursen
authors: N
authors: Postaci
authors: Lara
authors: L
authors: Pupim
authors: Ertap
authors: E
authors: Esi