RISK FACTORS FOR DEVELOPMENT OF CONTRAST INDUCED NEPHROPATHY IN PATIENTS UNDERGOING PERCUTANEOUS CORONARY INTERVENTION

Ikram Ullah, Farooq Ahmad, Muhammad Israr, Iqtidar Uddin, Mehmood Ul Hassan

Abstract


Background: Contrast induced nephropathy is a common form of acquired acute renal failure after coronary angiography and percutaneous coronary intervention (PCI) and this is associated with prolonge hospital stay and worse outcome. This study was conducted to find various risk factors responsible for contrast induced nephropathy in patients undergoing PCI.
Material & Methods: This was cross-sectional study performed at Hayatabad Medical Complex, Peshawar, Pakistan from July 01, 2014 to Dec. 31, 2014. Contrast induced nephropathy (CIN) is defined as increase in serum creatinine of ≥25% from baseline value and/ or an absolute increase of ≥0.5 mg/dl in serum creatinine from baseline. To identify independent characteristics associated with CIN, multivariable logistic regression analysis was used through SPSS version 15. Results of this model were presented as Odds Ratio (OR). P value was calculated to see the significance of various risk factors.
Results: We studied 177 patients with mean age of 60 ± 5.71 years. Overall frequency of CIN was found to be 10 %. CIN was found in 18.6 % of patients in older age group as compared to 5.9 % in younger age group (p-value =0.01, OR =3.6). In diabetic patients CIN was found in 19.2 % patients as compared to 6.4 % in non-diabetics (p-value =0.05, OR= 3.4). CIN was found in 40 % patients who were having baseline creatinine ≥ 1.5 mg/dl as compared to 8.4 % in <1.5mg/dl creatinine group (p-value =0.01, OR=7.2). In higher contrast dose (>150 ml), CIN frequency was significantly higher (13.7% vs. 3.3 %) and it was also significantly higher in patients with heart failure (33.3 % vs. 8 %).
Conclusion: Diabetes mellitus, heart failure, chronic kidney disease, advanced age and higher contrast dose were significantly associated with contrast induced nephropathy.

Keywords


Percutaneous Coronary Intervention; Contrast Induced Nephropathy; Diabetes Mellitus; Chronic Kidney Disease; Coronary Artery Bypass Grafting; Acute Kidney Injury.

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