| ObjectiveBy analyzing the levels of serum creatinine (Scr), blood urea nitrogen (BUN) and urine (β2-microglobulin (Uβ2-MG) before and at 3,7 days after Coronary Artery Intervention to study the risk factors of contrast-induced nephropathy (CIN) in patients undergoing coronary artery angiography (CAG) and/or percutaneous coronary intervention (PCI).Materials and Methods1. Subjects and Clinical dataTotal of 200 patients undergoing PCI or CAG from October 2008 to March 2009 were enrolled in this study. Age, sex, body height, body mass, blood pressure, drug application, dosage of contrast agent, Bun, Scr, Uβ2-MG, blood-lipid, blood glucose, primary disease were recorded.2. Exclusion criteriaPatients with severe renal dysfunction(GFR<15mL/min), severe illness, kidney transplanting history, adding newly ACEIs after PCI, taking non-steroidal anti-inflammatory drugs or other nephrotoxic drugs, severe allergies on Iodine-containing contrast agents and gravida.3. Perioperative treatmentAll patients were undergone standard CAG or PCI with low osmolar, non-ionic contrast agent. Normal saline intravenously drip at a rate of 1mL/(kg.h) for 6 hours before and 1mL/(kg.h) for 12 hours after contrast administration were adopted to promote the excretion of contrast agents.4. ObservationsThe levels of Scr, BUN and Uβ2-MG were measured before and at 3,7 days after PCI. creatinine clearance rate (Ccr) was calculated. Based on Scr level before and after PCI to determine the CIN group and non-CIN group and the basic clinical features between the two groups were compared. CIN was defined as a relative rise in SCr>25%, or as an absolute increase>44.2μmol/L from baseline.5. Statistical analysisData were analyzed with use of SPSS13.0. Continuous variables were presented as mean±standard deviation (SD). Categorical variables were presented as ratio or constituent ratio. Continuous variables were compared by t test or Wilcoxon signed rank test. Categorical variables were compared by chi-squared test or Fisher test. The independent risk factors were determined by using logistic regression. A two-tailed P<0.05 was considered as statistically significant.Results1. Among the 200 patients,14 patients developed CIN and the incidence of CIN was 7%, the BUN of all the patients was not found significant difference(P>0.05) before and after contrast administration.2. The Scr,Ccr,Uβ2-MG of the 18 patients with pre-existed renal dysfunction were found significant difference (P<0.05) before and at 3 days after contrast administration, but this difference was not statistically significant at 7 days after contrast administration(P>0.05).3. The Scr, Ccr of the 186 non-CIN patients was not found significant difference (P>0.05) before and at 3,7 days after contrast administration. However, the Uβ2-MG at 3 days after contrast administration was higher than that before contrast administration (P<0.05).There was no significant difference (P>0.05) between the Uβ2-MG before and at 7 days after contrast administration.4. The Scr, Ccr, Uβ2-MG of the 14 CIN patients had significant difference (P<0.05) before and at 3 days after contrast administration, but this difference was not statistically significant at 7 days after contrast administration (P>0.05). During hospitalization, no serious cardiovascular events and no renal replacement therapy were observed.5. The ratio of pre-existed renal dysfunction, hypertension,diabetes mellitus had significant difference (P<0.05) between CIN group and non-CIN group, but age, BMI (Body mass index), coronary arteriosclerosis, ACEIs, dosages of contrast agent, TC,TG,LDL was no significant difference (P>0.05). Identified by logistic regression analysis, the pre-existed renal dysfunction and diabetes mellitus were independent risk factors of CIN.Conclusions1. Pre-existed renal dysfunction and diabetes mellitus were independent risk factors of CIN.2. Hypertension is a related risk factor of CIN.3. Age, BMI, ACEIs, coronary arteriosclerosis, dosages of contrast agent and hyperlipemia were not risk factors of CIN.
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