title: Diabetes with preserved renal function is an independent risk factor for renal function deterioration after coronary computed tomography angiography.
abstract: OBJECTIVE
  Diabetes mellitus (DM) and high fasting glucose levels are reportedly risk factors for contrast-induced nephropathy after invasive coronary angiography in patients with renal dysfunction. Cystatin C (CyC) is a sensitive marker for detecting early impairment of renal function. Using CyC, we investigated whether DM would be a risk for worsening renal function after coronary computed tomography angiography (CCTA) in patients with preserved renal function.
  
  
  METHODS
  Two hundred twenty-eight patients scheduled for CCTA were enrolled. The serum CyC at preprocedure and 1 day after procedure, urinary microalbumin at preprocedure, and oral fluid volume for 24 hours after procedure were measured. The percentage changes in CyC from preprocedure to 1 day after procedure (%CyC) were also calculated.
  
  
  RESULTS
  Ninety-eight patients had DM. The %CyC and urinary microalbumin were significantly greater in DM patients than in non-DM patients. The percentage of patients showing a %CyC of 10% or greater was significantly greater in DM patients than in non-DM patients (27% vs 8%, P < 0.01). Using multivariate regression analysis, oral fluid volume and urinary microalbumin were independent predictors for a %CyC of 10% or greater in DM patients (β = - 0.428 [P < 0.0001] and β = 0.464 [P < 0.0001], respectively).
  
  
  CONCLUSIONS
  Diabetes mellitus is a risk factor for worsening changes in renal function after CCTA, even in patients with preserved renal function. In particular, elevated microalbuminuria and low oral fluid intake are high-risk factors for renal functional deterioration.
authors.affiliation: From the *Department of Cardiology, Isobe Naika Clinic, †Department of Cardiology, Nagoya University Graduate School of Medicine; and ‡Department of Cardiology and Divisions of §Radiological Technology and ∥Nursing, Kami-iida Dai-ichi General Hospital, Nagoya, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Isobe
authors.forename: Takashi
authors.initials: T
authors.lastname: Yamada
authors.forename: Kimihide
authors.initials: K
authors.lastname: Sato
authors.forename: Toshio
authors.initials: T
authors.lastname: Katagiri
authors.forename: Hisato
authors.initials: H
authors.lastname: Ohyama
authors.forename: Mutsuharu
authors.initials: M
authors.lastname: Hayashi
authors.forename: Daiji
authors.initials: D
authors.lastname: Yoshikawa
authors.forename: Hideki
authors.initials: H
authors.lastname: Ishii
authors.forename: Toyoaki
authors.initials: T
authors.lastname: Murohara
mesh_terms: D000368:Aged; D015415:Biomarkers; D015984:Causality; D015897:Comorbidity; D003287:Contrast Media; D017023:Coronary Angiography / Q000706:statistics & numerical data*; D055316:Cystatin C / Q000097:blood*; D048909:Diabetes Complications / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D064420:Drug-Related Side Effects and Adverse Reactions / Q000453:epidemiology; D005260:Female; D006801:Humans; D015994:Incidence; D007483:Iothalamic Acid; D007564:Japan / Q000453:epidemiology; D007674:Kidney Diseases / Q000097:blood / Q000000981:diagnostic imaging / Q000453:epidemiology*; D008297:Male; D018570:Risk Assessment; D014057:Tomography, X-Ray Computed / Q000706:statistics & numerical data*
chemical_list: D015415:Biomarkers; D003287:Contrast Media; D055316:Cystatin C; D007483:Iothalamic Acid