title: Incidence of contrast-induced acute kidney injury associated with diagnostic or interventional coronary angiography.
abstract: BACKGROUND
  Contrast-induced acute kidney injury (CI-AKI) represents an important cause of hospital-acquired AKI. The aim of this study was to evaluate the incidence of CI-AKI after coronary angiography (CA) or percutaneous coronary intervention (PCI) and the role of patient-/procedure-related risk factors.
  
  
  METHODS
  For 11 months, patients undergoing CA or PCI were prospectively evaluated for CI-AKI, and factors possibly affecting CI-AKI were analyzed. Statistical analysis was completed using Student's t-test, chi-square or Fisher exact test, and multivariate logistic regression.
  
  
  RESULTS
  Among 585 consecutive patients, incidence of CI-AKI was 5.1% (n=30) and renal replacement therapy was required in 10% of those (n=3). Incidence of CI-AKI was higher in patients with anemia or chronic kidney disease (CKD) associated with diabetes. Basal hemoglobin was significantly lower in CI-AKI patients while Mehran score, contrast medium (CM) volume, contrast ratio (CM volume / maximum contrast dose) and ratio glomerular filtration rate (CM volume / GFR) were significantly higher. Multivariate analysis selected a higher contrast ratio as a factor independently associated with a higher risk of CI-AKI which otherwise appeared to be lower with increasing basal hemoglobin.
  
  
  CONCLUSIONS
  The incidence of CI-AKI after CA or PCI was higher in patients with CKD associated with diabetes. Lower levels of basal hemoglobin appeared to be related to a higher risk of CI-AKI, and contrast media volume, especially if exceeding the dose adjusted for renal function, was a strong modifiable risk factor for CI-AKI.
authors.affiliation: Department of Nephrology and Urology, Policlinico Umberto I, Sapienza University, Rome, Italy. santo.morabito@uniroma1.it
authors.forename: Santo
authors.initials: S
authors.lastname: Morabito
authors.forename: Valentina
authors.initials: V
authors.lastname: Pistolesi
authors.forename: Giulia
authors.initials: G
authors.lastname: Benedetti
authors.forename: Angelo
authors.initials: A
authors.lastname: Di Roma
authors.forename: Riccardo
authors.initials: R
authors.lastname: Colantonio
authors.forename: Massimo
authors.initials: M
authors.lastname: Mancone
authors.forename: Gennaro
authors.initials: G
authors.lastname: Sardella
authors.forename: Loredana
authors.initials: L
authors.lastname: Cibelli
authors.forename: Mariacarmela
authors.initials: M
authors.lastname: Ambrosino
authors.forename: Francesca
authors.initials: F
authors.lastname: Polistena
authors.forename: Alessandro
authors.initials: A
authors.lastname: Pierucci
mesh_terms: D058186:Acute Kidney Injury / Q000097:blood / Q000139:chemically induced* / Q000453:epidemiology* / Q000628:therapy; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D016009:Chi-Square Distribution; D015897:Comorbidity; D003287:Contrast Media / Q000009:adverse effects*; D017023:Coronary Angiography / Q000009:adverse effects*; D003928:Diabetic Nephropathies / Q000453:epidemiology; D005260:Female; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D015994:Incidence; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D062645:Percutaneous Coronary Intervention; D011446:Prospective Studies; D015641:Radiography, Interventional / Q000009:adverse effects*; D051436:Renal Insufficiency, Chronic / Q000453:epidemiology; D017582:Renal Replacement Therapy; D012307:Risk Factors; D012384:Rome / Q000453:epidemiology; D013997:Time Factors; D055815:Young Adult
chemical_list: D015415:Biomarkers; D003287:Contrast Media; D006454:Hemoglobins