title: Proteinuria and Reduced Estimated Glomerular Filtration Rate Are Independent Risk Factors for Contrast-Induced Nephropathy After Cardiac Catheterization.
abstract: BACKGROUND
  The aim of this study was to investigate the incidence of contrast-induced nephropathy (CIN) according to renal function in patients with or without proteinuria after cardiac catheterization in Japan. METHODS AND RESULTS: We conducted a multicenter prospective observational study involving 27 hospitals from all over Japan, which enrolled 906 patients with cardiac catheterization. CIN was defined as increase in serum creatinine ≥0.5 mg/dl or ≥25% from baseline between 48 and 72 h after exposure to contrast. The incidence of CIN in patients with estimated glomerular filtration rate (eGFR) <30 ml/min/1.73 m2was significantly higher than that in patients with eGFR ≥60 ml/min/1.73 m2. In patients without proteinuria, the incidence of CIN did not increase as eGFR decreased, but such a trend was observed in patients with proteinuria. Proteinuria was highly significantly associated with CIN in patients with eGFR 30-44 ml/min/1.73 m2(OR, 12.1; 95% CI: 2.81-82.8; P=0.0006) and eGFR <30 ml/min/1.73 m2(OR, 17.4; 95% CI: 3.32-321; P=0.0001). On multivariate logistic regression analysis, proteinuria (OR, 4.09; 95% CI: 1.66-10.0), eGFR (OR, 1.02; 95% CI: 1.00-1.04), contrast volume/eGFR (OR, 1.31; 95% CI: 1.04-1.65), and Ca antagonist use (OR, 3.79; 95% CI: 1.52-10.8) were significant predictors of CIN.
  
  
  CONCLUSIONS
  Proteinuria and reduced eGFR are independent risk factors for CIN after cardiac catheterization.
authors.affiliation: First Department of Internal Medicine, Nara Medical University.
authors.forename: Yoshihiko
authors.initials: Y
authors.lastname: Saito
authors.forename: Makoto
authors.initials: M
authors.lastname: Watanabe
authors.forename: Kazutaka
authors.initials: K
authors.lastname: Aonuma
authors.forename: Atsushi
authors.initials: A
authors.lastname: Hirayama
authors.forename: Nagara
authors.initials: N
authors.lastname: Tamaki
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Tsutsui
authors.forename: Toyoaki
authors.initials: T
authors.lastname: Murohara
authors.forename: Hisao
authors.initials: H
authors.lastname: Ogawa
authors.forename: Takashi
authors.initials: T
authors.lastname: Akasaka
authors.forename: Michihiro
authors.initials: M
authors.lastname: Yoshimura
authors.forename: Akira
authors.initials: A
authors.lastname: Sato
authors.forename: Tadateru
authors.initials: T
authors.lastname: Takayama
authors.forename: Mamoru
authors.initials: M
authors.lastname: Sakakibara
authors.forename: Susumu
authors.initials: S
authors.lastname: Suzuki
authors.forename: Kenichi
authors.initials: K
authors.lastname: Ishigami
authors.forename: Kenji
authors.initials: K
authors.lastname: Onoue
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D006328:Cardiac Catheterization / Q000009:adverse effects*; D003287:Contrast Media / Q000008:administration & dosage / Q000009:adverse effects*; D005260:Female; D005919:Glomerular Filtration Rate / Q000187:drug effects*; D006801:Humans; D007674:Kidney Diseases / Q000139:chemically induced / Q000453:epidemiology / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011507:Proteinuria / Q000139:chemically induced / Q000453:epidemiology / Q000503:physiopathology
chemical_list: D003287:Contrast Media