Analysis Of The Related Risk Factors Of Contrast-Induced Nephropathy In Patients Undergoing Percutaneous Coronary Intervention

Background Because contrast media are being widely applied for percutaneous coronary intervention, contrast-induced nephropathy (CIN) is the third leading cause of hospital-acquired acute renal failure. The development of contrast-induced nephropathy(CIN) is associated with prolonged in-hospital stay and increased mortality and cost, patients at the greatest risk contrast-induced nephropathy can be defined as those suffering from age, impaired renal function, the coronary heart disease (CHD),diabetes mellitus,heart failure, using of the volume contrast media and other risk factors. This purposes aims to investigate the incidence and the risk factors of contrast-induced nephropathy in patients undergoing coronary angiography and percutaneous coronary intervention.Objective This purposes aims to investigate the incidence and the risk factors of contrast-induced nephropathy in patients undergoing coronary angiography and percutaneous coronary interventionMethods From October2010to April2011,a total of672patients undergoing coronary angiography and percutaneous coronary intervention were recruited, date, name, sex, age, body-weight, co-morbidities (including hypertension, coronary heart disease(CHD),diabetes mellitus,heart failure, anemia), use of drugs (including angiotensin converting enzyme inhibitors(ACEI), diureties metformin), and the volume of contrast media were doetimented. The contrast-induced nephropathy(CIN) is identified if the serum creatinine is increased by44.2μ mol/L (0.5mg/dL) or25%of the baseline at48hours post procedur. The incidence and the rick factors of contrast-induced nephropathy(CIN) were analyzed.Results (1) Of the all672patienis,451(67.1%)were male and221(32.9%)were female. The average age was62.34±11.54years.292(43.5%)were aged over≥65,588(87.5%) had coronary heart disease,461(68.6%)had hypertension,144(21.4%) had diabetes mellitus,42(6.3%) had anemia,30(4.5%) had Scr more than110μmol/L,and the average Scr was72.02±20.75μmol/L before procedur,237(35.3%) had the voluem of contrast meida≥200ml. and the average voluem of contrast meida was164.29±85.74ml,344(51.2%) took ACEI,95(14.1%) took diuretics,39(5.8%) took metformins.(2) Among the672patients, CIN occurred in55patients and the incidence of the contrast-induced nephropathy(CIN) was8.2%.the incidence of the CIN of the age≥65was12%(35/292),the male was8.9%(40/451), the coronary heart disease was9%(53/588), the hypertension was8.2%(38/461), the diabetes mellitus was9%(13/144), the anemia was7.1%(3/42), the Scr more than110μmol/L was16.7%(5/30),the patients took ACEI was7.6%(26/344),the patiens took diuretics was13.7%(13/95), the patiens took metformins was7.7%(3/39), the voluem of contrast meida≥200ml was12.2%(29/237).(3) among the patients of the age≥65,35patients experienced CIN and the incidence was9.1%. while among the patients of the age<65,20patients experienced CIN and the incidence was5.2%, There was significant difference regarding the incidence of CIN between the two groups (P=0.002). among the patients of the voluem of contrast meida≥200ml,29patients experienced CIN and the incidence was12.2%. while among the patients of the voluem of contrast meida<200ml,26patients experienced CIN and the incidence was5.9%There was significant difference regarding the incidence of CIN between the two groups (P=0.005). among the patients with the coronary heart disease,53patients experienced CIN and the incidence was9.0%. while among the patients without the coronary heart disease,2patients experienced CIN and the incidence was2.3%There was significant difference regarding the incidence of CIN between the two groups (P=0.038). among the patients took diuretics,13patients experienced CIN and the incidence was13.7%. while among the patients without diuretics,42patients experienced CIN and the incidence was7.27%There was significant difference regarding the incidence of CIN between the two groups (P=0.035)Conclusions there were significant differences between CIN and non-CIN patients in terms of ages over65, coronary heart disease, the voluem of contrast meida≥200ml. diuretics(P<0.05). while there were no significant differences between CIN and non-CIN patients in terms of sex, hypertension, diabetes mellitus, anemia, the a Scr before procedur, ACEI, diureties,metformin. Logistic regression analysis showed that age≥65, the voluem of contrast meida≥200ml were independent risk factors of CIN.