Contrast-induced nephropathy: current practices among cardiologists.
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.
Alhosaini
Mohamad N
MN
Department of Internal Medicine, Saint Joseph Hospital, University of Illinois at Chicago, Chicago, Illinois, USA. mnh811@gmail.com
Latta
Shadi
S
Riaz
Kamran
K
Hamdi
Tamim
T
Jallad
Bassel
B
Kheir
Fayez
F
Park
Sook
S
Iroegbu
Nkemakolam
N
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
D003287:Contrast Media