EARLY CREATININE SHIFTS PREDICT CONTRAST-INDUCED NEPHROPATHY AND PERSISTENT RENAL DAMAGE AFTER ANGIOGRAPHY.

Giovanni Gambaro, Flavio Ribichini, Mariastella Graziani, Paolo Pasoli, Michele Pighi, Gabriele Pesarini, Cataldo Abaterusso, Tewoldemedhn Yabarek, Sandra Brunelleschi, Paolo Rizzotti, Antonio Lupo, Corrado Vassanelli

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48 Citazioni (Scopus)

Abstract

PURPOSE: The purpose of this study was to evaluate incidence and predictors of contrast-induced nephropathy after coronary angiography and interventions, and to assess renal function at 30 days. The prognostic value of any early shift of serum creatinine compared with baseline was investigated; such measurement, being a delta, is largely independent of creatinine variations. METHODS: There were 216 patients at risk for contrast-induced nephropathy prospectively evaluated at baseline and at 12, 24, and 48 hours after exposure to contrast media, and 190 (88%) evaluated 1 month after discharge. RESULTS: Contrast-induced nephropathy occurred in 39 patients (18%), and 30-day renal damage was detected in 15 (7%). Contrast media/kg volume predicted contrast-induced nephropathy (P=.002), and percentage change of creatinine 12 hours from baseline was significantly higher in patients with nephropathy (P <.001). At multivariate analysis, percentage change of creatinine 12 hour-basal was the best predictor of nephropathy (P <.001). A 5% increase of its value yielded 75% sensitivity and 72% specificity (area under the curve 0.80; odds ratio 7.37; 95% confidence interval, 3.34-16.23) for early contrast-induced nephropathy detection. Furthermore, it strongly correlated with the development of renal impairment at 30 days (P=.002; sensitivity 87%, specificity 70%; area under the curve 0.85; odds ratio 13.29; 95% confidence interval, 2.91-60.64). CONCLUSION: Minimal elevations of serum creatinine at 12 hours are highly predictive of contrast-induced nephropathy and 30-day renal damage after exposure to contrast media.
Lingua originaleEnglish
pagine (da-a)755-763
Numero di pagine9
RivistaTHE AMERICAN JOURNAL OF MEDICINE
Volume123
Stato di pubblicazionePubblicato - 2010

Keywords

  • AKI
  • contrast nephropathy

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