Evaluation of prediction score of contrast-induced nephropathy in inpatients undergone to digital or CT angiography
Main Article Content
Abstract
Objectives: To assess the incidence of contrast-induced nephropathy (CIN) and determine the Mehran Score's (MS) ability to predict CIN in patients undergoing digital angiography or computed tomography angiography. Methods: 252 medical records of inpatients who underwent DA or CTA over 28 months in a quaternary hospital were reviewed. CIN was defined as serum creatinine> 0.5 mg / dL or > 25% increase in baseline creatinine, 48 h after administration of iodinated contrast. The ROC curve and the area under the curve (AUC) were used as a score test. Results: The majority (159; 63.1%) were male, and the average age was 60.4 years. Anemia, diabetes mellitus, and age > 75 years were the most prevalent factors. The incidence of CIN was 17.8% (n = 45). There was a decrease in the mean values of creatinine pre and post among patients who did not suffer CIN (1.38 ± 1.22 vs 1.19 ± 0.89; t = 3.433; p = 0.0007), while among patients who suffering CIN, the mean increase was 1.03 mg / dL (1.43 ± 1.48 vs 2.46 ± 2.35 mg / dL; t = 5.44; p = 0.117). The ROC curve analysis identified a low correlation between MS and the occurrence of CIN (AUC = 0.506). Conclusion: The incidence of CIN in hospitalized patients undergoing angiography or computed tomography angiography was high. The EM did not allow the prediction of NIC.
Article Details
Authors maintain copyright and grant the HSJ the right to first publication. From 2024, the publications wiil be licensed under Attribution 4.0 International , allowing their sharing, recognizing the authorship and initial publication in this journal.
Authors are authorized to assume additional contracts separately for the non-exclusive distribution of the version of the work published in this journal (e.g., publishing in an institutional repository or as a book chapter), with acknowledgment of authorship and initial publication in this journal.
Authors are encouraged to publish and distribute their work online (e.g., in institutional repositories or on their personal page) at any point after the editorial process.
Also, the AUTHOR is informed and consents that the HSJ can incorporate his article into existing or future scientific databases and indexers, under the conditions defined by the latter at all times, which will involve, at least, the possibility that the holders of these databases can perform the following actions on the article.
References
Mehran R, Aymong ED, Nikolsky E, et al. A simple risk score for prediction of contrast-induced nephropathy after percutaneous coronary intervention. J Am Coll Cardiol 2004;44(7):1393-99. https://doi.org10.1016/j.jacc.2004.06.068
Vijay SK, Tiwari BC, Singh AK. Contrast induced nephropathy: pathophysiology and prevention. Heart India. 2013;1(2);39-45. https://doi.org/10.4103/2321-449x.118580
Maccariello E. Nefropatia Induzida por contraste. J Bras Nefrol. 2016;38(4):388-9. https://doi.org/10.5935/0101-2800.20160062 PMid:28001182
Kuo C, Chou R, Lu Y, et al. Increased circulating galectin-1 levels are associated with the progression of kidney function decline in patients undergoing coronary angiography. Sci Rep.2020;10:1435. https://doi.org/10.1038/s41598-020-58132-1 PMid:31996694 PMCid:PMC6989666
Santos RO, Malvar B, Silva R, et al. Nefropatia de contraste. Acta Med Port [Internet]. 2011 [cited 2020 Sep 9];24: 809-20. Avaiable from: actamedicaportuguesa.com/revista/index.php/amp/article/viewFile/504/212
Kramer CK, Leitão CB, Canani LH, Gross JL, Silveiro SP. Contrast-induced nephropathy: prevention strategies. Clin Biomed Res [Internet]. 2008 [cited 2020 Sep 9];28(1): 33-6. Avaiable from: https://seer.ufrgs.br/hcpa/article/view/3177
Pyka Ł, Hawranek M, Wilczek K, Piegza J, Szkodzinski J, Lekston A, et al. Imaging-guided percutaneous coronary intervention with ultra-low contrast angiographic control for patients at extreme risk of contrast induced nephropathy. Cardiol J. 2019;26(6):796-8. https://doi.org/10.5603/CJ.2019.0117 PMid:31970738
Moura ELB, Amorim FF, Huang W, Maia MO. Lesão renal aguda induzida por contraste: importância dos critérios diagnósticos para estabelecer a prevalência e o prognóstico na unidade de terapia intensiva. Rev Bras Ter Intensiva. 2017;29(3):303-9. https://doi.org/10.5935/0103-507X.20170041 PMid:28876404 PMCid:PMC5632972
Reddan D, Laville M, Garovic VD. Contrast-induced nephropathy and its prevention: What do we really know from evidence-based findings? J Nephrol. 2009;22(3):333-51. PMID: 19557710
Santos PR, Neto JDC, Arcanjo FPN, Carneiro RCCP, Amaral CL. Contrast-induced nephropathy after primary angioplasty for acute myocardial infarction. J Bras Nefrol. 2015;37(4):439-45. https://doi.org/10.5935/0101-2800.20150070
Machado MC, Castagna MT, Reis G, Motta MS, Oliveira JV, Oliveira AL, Campos Neto MS. Nefropatia por radiocontraste: tendências atuais. Rev Bras Cardiol Invas. 2003;11(4):27-30.
Gouveia R, Bravo P, Santos C, Ramos A. Contrast-induced acute kidney injury - a review focusing on prophylactic strategies. Angiol Cir Vasc [Internet]. 2015 [cited 2020 Sep 9];11(2):68-78. https://doi.org/10.1016/j.ancv.2015.01.009
Evola S, Lunetta M, Macaione F, Fonte G, Milana G, Corrado E, Bonura F, Novo G, Hoffmann E, Novo S. Risk factors for contrast induced nephropathy: a study among Italian patients. Indian Heart J. 2012;64(5):484-91. https://doi.org/10.1016/j.ihj.2012.07.007 PMid:23102387 PMCid:PMC3860804
Raingruber B, Kirkland-Walsh H, Chahon N, Kellermann M. Using the Mehran risk scoring tool to predict risk for contrast medium-induced nephropathy in patients undergoing percutaneous angiography. Crit Care Nurse. 2011;31(1):e17-e22. https://doi.org/10.4037/ccn2011746 PMid:21285460
Sgura FA, Bertelli L, Monopoli D, et al. Mehran contrast-induced nephropathy risk score predicts short- and long-term clinical outcomes in patients with ST-elevation-myocardial infarction. Circ Cardiovasc Interv. 2010;3(5):491-498. https://doi.org/10.1161/CIRCINTERVENTIONS.110.955310 PMid:20923986
Antunes LF, Baptista A, Moreira J, Anacleto G, Gonçalves Ó, Matos A. Insuficiência renal induzida por contraste: estudo prospectivo. Angiol Cir Vasc [Internet]. 2013 [cited 2020 Sep 10];9(2):59-63. https://doi.org/10.1016/S1646-706X(13)70017-X
Ortega LM, Harmouch I, Nayer A. Contrast-induced nephropathy: pathogenesis and new therapeutic options for prevention. Am J Ther. 2015;22(6):469-476. https://doi.org/10.1097/MJT.0000000000000163 PMid:25470612
Wi J, Ko YG, Shin DH, et al. Prediction of Contrast-Induced Nephropathy With Persistent Renal Dysfunction and Adverse Long-term Outcomes in Patients With Acute Myocardial Infarction Using the Mehran Risk Score. Clin Cardiol. 2013;36(1):46-53. https://doi.org/10.1002/clc.22060 PMid:23027701 PMCid:PMC6649613
Funaki B. Contrast-induced nephropathy: what we know, what we think we know, and what we don't know. Semin Intervent Radiol. 2005;22(2):108-13. https://doi.org/10.1055/s-2005-871865 PMid:21326680 PMCid:PMC3036263
Zungur M, Gul I, Tastan A, Damar E, Tavli T. Predictive value of the Mehran Score for contrast-induced nephropathy after transcatheter aortic valve implantation in patients with aortic stenosis. Cardiorenal Med. 2016;6(4):279-288. https://doi.org/10.1159/000443936 PMid:27648009 PMCid:PMC5020403
Sadat U, Walsh SR, Norden AG, Gillard JH, Boyle JR. Does oral N-acetylcysteine reduce contrast-induced renal injury in patients with peripheral arterial disease undergoing peripheral angiography? A randomized-controlled study. Angiology. 2011;62(3):225-230. https://doi.org/10.1177/0003319710377078 PMid:20682612
Abellás-Sequeiros RA, Raposeiras-Roubín S, Abu-Assi E, et al. Mehran contrast nephropathy risk score: Is it still useful 10 years later?. J Cardiol. 2016;67(3):262-267. https://doi.org/10.1016/j.jjcc.2015.05.007 PMid:26169247
Ni Z, Liang Y, Xie N, et al. Simple pre-procedure risk stratification tool for contrast-induced nephropathy [published correction appears in J Thorac Dis. 2019;11(7):E105]. J Thorac Dis. 2019;11(4):1597-1610. https://doi.org/10.21037/jtd.2019.04.69 PMid:31179104 PMCid:PMC6531701