Risk for contrast nephropathy in patients undergoing coronarography.
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.
La Manna
Gaetano
G
Department of Internal Medicine, Aging and Renal Disease-Section of Nephrology, University of Bologna, Bologna, Italy. gaetano.lamanna@unibo.it
Pancaldi
Leonardo Goffredo
LG
Capecchi
Alessandro
A
Maska
Edlira
E
Comai
Giorgia
G
Cappuccilli
Maria L
ML
Carretta
Elisa
E
Lombardi
Alessandro
A
Colì
Luigi
L
Stefoni
Sergio
S
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
D003287:Contrast Media