title: Contrast-induced nephropathy: current practices among cardiologists.
abstract: OBJECTIVE
  Contrast-induced nephropathy (CIN) is a serious complication of diagnostic and therapeutic coronary angiography. There are an increasing number of guidelines in the literature to help lessen this complication. Practice patterns in the cardiology community remain relatively unknown. This survey is an effort to better understand such practices.
  
  
  METHODS
  Questions were written based on the American College of Cardiology (ACC), the American Heart Association (AHA), and the Society of Cardiovascular Angiography and Intervention (SCAI) guidelines to identify cardiologist background and experience. The survey was emailed to 5000 randomly chosen cardiologists in December 2009.
  
  
  RESULTS
  A total of 291 responses were received. Among these, 97% reported checking renal function in all patients prior to angiography, 45% checked both estimated glomerular filtration rate (eGFR) and serum creatinine (SCr), 31% checked SCr alone, 19% checked eGFR alone, and 2% checked albumin-to-creatinine (A-C) ratio. Among responding cardiologists, 70% considered eGFR level less than 60 mL/min/1.73 m(2) a high risk for CIN whereas 25% considered a level less than 30 mL/min/1.73 m(2) a high risk. Thirty percent used only isosmolar media in high-risk patients, 33% used only low osmolar media, and 37% used either one.
  
  
  CONCLUSIONS
  There is significant diversity in the measures taken by cardiologists to prevent CIN. More studies and clearer guidelines are needed to unify the practices.
authors: Department of Internal Medicine, Saint Joseph Hospital, University of Illinois at Chicago, Chicago, Illinois, USA. mnh811@gmail.com
authors: Mohamad N
authors: MN
authors: Alhosaini
authors: Shadi
authors: S
authors: Latta
authors: Kamran
authors: K
authors: Riaz
authors: Tamim
authors: T
authors: Hamdi
authors: Bassel
authors: B
authors: Jallad
authors: Fayez
authors: F
authors: Kheir
authors: Sook
authors: S
authors: Park
authors: Nkemakolam
authors: N
authors: Iroegbu
mesh_terms: D002309:Cardiology; D002983:Clinical Competence; D003287:Contrast Media / Q000009:adverse effects*; D017023:Coronary Angiography; D019538:Health Care Surveys; D006764:Hospitals, Community; D006784:Hospitals, Teaching; D006801:Humans; D007677:Kidney Function Tests; D018579:Patient Selection; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians'; D051437:Renal Insufficiency / Q000139:chemically induced* / Q000175:diagnosis* / Q000628:therapy; D012307:Risk Factors
chemical_list: D003287:Contrast Media