title: Lower blood vitamin D levels are associated with an increased incidence of contrast-induced nephropathy in patients undergoing coronary angiography.
abstract: BACKGROUND
  Vitamin D deficiency may be associated with an increased risk of renovascular disease. We assessed the correlation between vitamin D levels and contrast-induced nephropathy (CIN) in patients undergoing coronary angiography (CAG).
  
  
  METHODS
  Vitamin D and parathyroid hormone (PTH) levels were assessed before CAG in 403 patients. Estimated glomerular filtration rate (eGFR) was calculated using the Cockcroft-Gault equation. Patients with eGFR < 60 mL/min/1.73 m(2) were hydrated with 0.9%-saline at 1 mL/kg/h for 12 hours before and after CAG. CIN was defined as serum creatinine increase of > 0.5 mg/dL or > 25% within 48-72 hours after CAG.
  
  
  RESULTS
  CIN developed in 74 participants. Baseline eGFR, blood urea and creatinine in CIN (+) and (-) groups were not significantly different (P = 0.14, P = 0.07, and P = 0.61, respectively). Total volume of contrast medium (CM) was higher in the CIN (+) group (132 ± 64 mL vs 90 ± 41 mL; P = 0.01). Vitamin D levels were lower (median 8.5 [range, 0.5-26.6] ng/mL vs 14.9 [range, 1.9-93.5] ng/mL; P = 0.01) and PTH levels were higher (median 73.9 [range, 22-530] pg/mL vs 44.2 [range, 5-361] pg/mL; P = 0.01) in the CIN (+) group. Multivariate logistic regression analysis revealed that lower vitamin D levels (odds ratio [OR], 1.18; 95% confidence interval [CI], 1.11-1.26; P = 0.01) and increased CM volume (OR, 1.01; 95% CI, 1.008-1.017; P = 0.01) were independently correlated with CIN. In patients who had undergone percutaneous coronary intervention, lower levels of vitamin D were independently associated with CIN development.
  
  
  CONCLUSIONS
  Lower vitamin D levels, implying possible vitamin D deficiency, are associated with a higher incidence of CIN.
authors.affiliation: Department of Cardiology, Bagcılar Research and Education Hospital, Istanbul, Turkey.
authors.forename: Irfan
authors.initials: I
authors.lastname: Sahin
authors.affiliation: Department of Cardiology, Siyami Ersek Cardiovascular and Thoracic Surgery Center, Istanbul, Turkey. Electronic address: drbarisgungor@gmail.com.
authors.forename: Baris
authors.initials: B
authors.lastname: Gungor
authors.affiliation: Department of Cardiology, Bagcılar Research and Education Hospital, Istanbul, Turkey.
authors.forename: Mehmet Mustafa
authors.initials: MM
authors.lastname: Can
authors.affiliation: Department of Cardiology, Bagcılar Research and Education Hospital, Istanbul, Turkey.
authors.forename: Ilhan Ilker
authors.initials: II
authors.lastname: Avci
authors.affiliation: Department of Cardiology, Istınye State Hospital, Istanbul, Turkey.
authors.forename: Gamze Babur
authors.initials: GB
authors.lastname: Guler
authors.affiliation: Department of Cardiology, Bagcılar Research and Education Hospital, Istanbul, Turkey.
authors.forename: Ertugrul
authors.initials: E
authors.lastname: Okuyan
authors.affiliation: Department of Cardiology, Bagcılar Research and Education Hospital, Istanbul, Turkey.
authors.forename: Halil
authors.initials: H
authors.lastname: Biter
authors.affiliation: Department of Cardiology, Bagcılar Research and Education Hospital, Istanbul, Turkey.
authors.forename: Suleyman Sezai
authors.initials: SS
authors.lastname: Yildiz
authors.affiliation: Department of Cardiology, Bagcılar Research and Education Hospital, Istanbul, Turkey.
authors.forename: Burak
authors.initials: B
authors.lastname: Ayca
authors.affiliation: Department of Cardiology, Siyami Ersek Cardiovascular and Thoracic Surgery Center, Istanbul, Turkey.
authors.forename: Seckin
authors.initials: S
authors.lastname: Satilmis
authors.affiliation: Department of Cardiology, Bagcılar Research and Education Hospital, Istanbul, Turkey.
authors.forename: Mustafa Hakan
authors.initials: MH
authors.lastname: Dinckal
mesh_terms: D000368:Aged; D003287:Contrast Media / Q000008:administration & dosage / Q000009:adverse effects*; D017023:Coronary Angiography; D003404:Creatinine / Q000097:blood; D004305:Dose-Response Relationship, Drug; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007674:Kidney Diseases / Q000139:chemically induced*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010281:Parathyroid Hormone / Q000097:blood; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D014807:Vitamin D / Q000097:blood*; D014808:Vitamin D Deficiency / Q000150:complications
chemical_list: D003287:Contrast Media; D010281:Parathyroid Hormone; D014807:Vitamin D; D003404:Creatinine