title: Risk for contrast nephropathy in patients undergoing coronarography.
abstract: Among the causes of in-hospital acute renal failure, contrast-induced nephropathy ranks third in prevalence. Although it represents a condition of renal impairment with spontaneous recovery, contrast nephropathy should always be considered, because it prolongs hospitalization and it may become a severe complication requiring dialysis. The purposes of this study are: (i) to determine if the application of the most effective contrast-induced nephropathy prevention strategies in the Cardiology Intensive Care Unit can prove to be successful in reducing nephropathy risk; and (ii) to identify which of the involved risk factors persist after the preventive treatment. We examined the patients who had a coronarography at the Bentivoglio hospital from April 2007 to April 2008 who required at least 3 days of permanence in hospital due to the presence of potential risk factors; 136 out of 784 patients were included. Among the selected patients, 21 (15.44%) developed a renal impairment compatible with contrast-induced nephropathy. The risk factors that seemed to display the best correlation with risk of contrast nephropathy were advanced age and an ventricular failure (ejection fraction <40%); however, the critical condition did not appear to be due to a single risk factor, but it resulted from the association of more contextual risk factors. Particularly, the concomitant presence of ventricular failure, anemia, diabetes, previous myocardial infarction and advanced age (>70 years) determined a threefold increased risk of contrast nephropathy. Our data suggest that the development of contrast nephropathy following coronarography is associated with worse renal function during hospitalization and at discharge.
authors.affiliation: Department of Internal Medicine, Aging and Renal Disease-Section of Nephrology, University of Bologna, Bologna, Italy. gaetano.lamanna@unibo.it
authors.forename: Gaetano
authors.initials: G
authors.lastname: La Manna
authors.forename: Leonardo Goffredo
authors.initials: LG
authors.lastname: Pancaldi
authors.forename: Alessandro
authors.initials: A
authors.lastname: Capecchi
authors.forename: Edlira
authors.initials: E
authors.lastname: Maska
authors.forename: Giorgia
authors.initials: G
authors.lastname: Comai
authors.forename: Maria L
authors.initials: ML
authors.lastname: Cappuccilli
authors.forename: Elisa
authors.initials: E
authors.lastname: Carretta
authors.forename: Alessandro
authors.initials: A
authors.lastname: Lombardi
authors.forename: Luigi
authors.initials: L
authors.lastname: Colì
authors.forename: Sergio
authors.initials: S
authors.lastname: Stefoni
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003287:Contrast Media / Q000009:adverse effects*; D017023:Coronary Angiography / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007674:Kidney Diseases / Q000139:chemically induced* / Q000453:epidemiology; D008297:Male; D012307:Risk Factors
chemical_list: D003287:Contrast Media