title: An uninvestigated risk factor for contrast-induced nephropathy in chronic kidney disease: proteinuria.
abstract: BACKGROUND
  Contrast-induced nephropathy (CIN) is one of the most frequent causes of acute renal failure in hospitalized patients with the incremental use of contrast media. We aimed to investigate whether proteinuria may act as a risk factor for CIN in patients with chronic kidney disease.
  
  
  METHODS
  Seventy hospitalized patients (37 men, 33 women) with chronic kidney disease, proteinuria, and/or estimated glomerular filtration rate (eGFR) of <60 mL/min/1.73 m2, who were exposed to contrast media were investigated prospectively. Thirty patients were diabetic. All patients received prophylaxis against CIN with acetylcysteine and 0.9% intravenous saline. CIN is defined as either a 25% higher increase in serum creatinine (sCr) from the baseline levels or a 0.5 mg/dL increase in sCr at 72 h after contrast media exposure.
  
  
  RESULTS
  CIN was detected in 26 (37.1%) patients. Advanced age, diabetes, heart failure, anemia, baseline sCr of >1.5 mg/dL, baseline eGFR of <60 mL/min/1.73 m(2), proteinuria of ≥1 g/day, hypoalbuminemia, and the volume of contrast media of ≥100 mL correlated significantly with CIN. The frequency of CIN was significantly higher in patients with proteinuria of ≥1 g/day compared to patients with proteinuria of <1 g/day (p = 0.009).
  
  
  CONCLUSIONS
  Proteinuria may be a new risk factor for the development of CIN in patients with chronic kidney disease.
authors.affiliation: Department of Internal Medicine, Hacettepe University Faculty of Medicine, Ankara, Turkey. svppasa@yahoo.com
authors.forename: Serhan
authors.initials: S
authors.lastname: Piskinpasa
authors.forename: Bulent
authors.initials: B
authors.lastname: Altun
authors.forename: Hadim
authors.initials: H
authors.lastname: Akoglu
authors.forename: Tolga
authors.initials: T
authors.lastname: Yildirim
authors.forename: Kemal
authors.initials: K
authors.lastname: Agbaht
authors.forename: Rahmi
authors.initials: R
authors.lastname: Yilmaz
authors.forename: Bora
authors.initials: B
authors.lastname: Peynircioglu
authors.forename: Barbaros
authors.initials: B
authors.lastname: Cil
authors.forename: Kudret
authors.initials: K
authors.lastname: Aytemir
authors.forename: Cetin
authors.initials: C
authors.lastname: Turgan
mesh_terms: D058186:Acute Kidney Injury / Q000097:blood / Q000453:epidemiology / Q000209:etiology*; D003287:Contrast Media / Q000009:adverse effects*; D017023:Coronary Angiography / Q000009:adverse effects; D003327:Coronary Disease / Q000150:complications / Q000000981:diagnostic imaging; D003404:Creatinine / Q000097:blood; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011507:Proteinuria / Q000097:blood / Q000139:chemically induced* / Q000150:complications; D051436:Renal Insufficiency, Chronic / Q000150:complications*; D012307:Risk Factors; D014421:Turkey / Q000453:epidemiology
chemical_list: D003287:Contrast Media; D003404:Creatinine