Predictors Of Contrast-induced Nephropathy In Patients With Chronic Total Occlusion Who Underwent Percutaneous Coronary Intervention

Background:Recent years, the rapid development of material engineering leads to the increasing usage of cardiac catheterization for the diagnosis and therapy for cardiac disease. Consequently, there was a raise application and frequency for patients’ exposure to contrast-media. Hence, the incidence of renal injury which attributed to contrast-media exposure was increase rapidly. Now sort of available research found that the incidence of contrast-induced kidney injury was 11% among the hospital-acquired renal injury. Contrast-induced nephropathy was one of the three major cause of hospital-acquired renal injury. Generally, the contrast-induced kidney injury is a transient pathological and physiological process. But in some cases contrast-induced nephropathy may prolong the clinical course and complicate the clinical condition. Even it may leads the transient renal injury to the permanent renal function loss which need a lifetime of renal replacement therapy. Previous studies has showed that, the incidence of contrast-induced nephropathy was among 7%-15%, and may be vary widely between different populations.ObjectiveTo investigate the risk factors of contrast-induced nephropathy(CIN) in patients with chronic total occlusion(CTO) who underwent percutaneous coronary intervention(PCI).Methods300 CTO patient underwent PCI were recruited from Guangdong general hospital. Patients were divided into CIN and non-CIN group. CIN was defined as an increase in serum creatinine of more than 44.2umol/l or 25% from baseline value within 48-72 hours after PCI procedure. Baseline characteristics and in hospital clinical events were compared between two groups. Logistic regression was used to investigate the predictors of CIN.Result300 patients with CTO were recruited and 30(11.7%) of them were developed CIN. the proportion of hypertension, type-2 diabetic mellitus, male and dyslipidemia were not significant difference between CIN and non-CIN group (P>0.05). The patients of CIN group were more likely with lower eGFR(P<0.05). And the proportion of patients with age>75years, LVEF<45%, hypoproteinemia, anemia were higher in CIN group than non-CIN group(P<0.05). Logistic regression analysis found that age>75years, LVEF<45%, lower eGFR were strongly correlated with CIN incidence.Conclusion1. Age>75years, LVEF<45% and low eGFR might be the predictors of CIN in patients with CTO after coronary intervention.2. Development of CIN may probably increase the risk of in-hospital events.