title: [Contrast-induced nephropathy after cardiac catheterization: a prospective study of 180 patients].
abstract: BACKGROUND
  Contrast-induced nephropathy (CIN) is associated with an increased cardiovascular morbi-mortality. Little is known about the incidence and risk factors of CIN after cardiac catheterization in Tunisian patients.
  
  
  OBJECTIVE
  To determine the incidence of CIN and its predictors after coronary angiography as well as its prognostic and therapeutic repercussions in a Tunisian patients' cohort.
  
  
  METHODS
  In this prospective single center study, 180 consecutive patients who underwent cardiac catheterization were enrolled; all patients were followed-up for 3 months.
  
  
  RESULTS
  The incidence of CIN defined as an absolute increase in serum creatinine ³ 5 mg/l (44μmol/l) and/or a relative increase in serum creatinine ³ 25%, was 17.2%. In multivariate logistic regression, independent predictors of CIN were: diabetes mellitus (Odds Ratio (OR)=2.26 ; 95% confidence interval (95%CI) : 1.29- 3.98, p=0.005), creatinine clearance < 80ml/mn (OR=2.87 ; 95%CI : 1.59-5.19, p<0.001), left ventricular ejection fraction (LVEF) < 45% (OR=2.03 ; 95%CI : 1.22-3.39, p=0.007) and use of a volume of contrast media > 90ml (1.72 ; 95%CI : 0.99-2.99, p=0.05). Perprocedural hypotension was the strongest independent predictor of CIN in our study (OR=3.99; 95% CI: 1.65-9.66, p=0.002). CIN was totally regressive within one month in 27 patients (86.7%) while 3 patients (10%) had a residual renal dysfunction at the end of the follow-up period (3 months).
  
  
  CONCLUSIONS
  More than one angiocoronarography on 6 resulted in CIN in our population. CIN affects cardiovascular prognosis even if renal function normalization is usually obtained within one month after the investigation. Besides identifying risk factors of CIN in order to apply preventive measures in risky patients, we stress the necessity of insuring a good hemodynamic status while achieving the procedure.
authors.affiliation: Hopital la Rabta de Tunis, Tunisie.
authors.forename: Fathia
authors.initials: F
authors.lastname: Mghaieth
authors.forename: Jihen
authors.initials: J
authors.lastname: Ayari
authors.forename: Rym
authors.initials: R
authors.lastname: Ben Rejeb
authors.forename: Sihem
authors.initials: S
authors.lastname: Mbarki
authors.forename: Abdeljelil
authors.initials: A
authors.lastname: Farhati
authors.forename: Noureddine
authors.initials: N
authors.lastname: Larbi
authors.forename: Rafik
authors.initials: R
authors.lastname: Boussaada
authors.forename: Mohamed S
authors.initials: MS
authors.lastname: Mourali
authors.forename: Rachid
authors.initials: R
authors.lastname: Mechmeche
mesh_terms: D058186:Acute Kidney Injury / Q000139:chemically induced*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006328:Cardiac Catheterization; D003287:Contrast Media / Q000009:adverse effects*; D017023:Coronary Angiography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors
chemical_list: D003287:Contrast Media