#2965 DYNAMICS OF THE FUNCTIONAL STATE OF THE KIDNEYS IN PATIENTS WITH DIABETES MELLITUS AND A HIGH RISK OF CI-AKI AND THE USE OF PREVENTIVE MEASURES

Abstract

Abstract Background and Aims Analysis of the pathogenetic mechanisms of the development of contrast nephropathy in patients with coronary artery disease on the background of type 2 diabetes mellitus and the effectiveness of the proposed preventive measures. Method The study included 56 patients with type 2 diabetes, the average age of the patients was 58 years, the CG consisted of 20 healthy persons. In most patients, the reason for which the endovascular radiopaque procedure (EVRCP) was performed was associated with atherosclerotic lesions: coronary artery disease, chronic lower limb ischemia (CLLI), atherosclerosis of the brachiocephalic arteries (BCA). EVRCP was performed on the vessels of the coronary basin, BCA, abdominal aorta and its branches, lower extremities. A retrospective analysis included a comparative analysis of two groups of patients with type 2 diabetes who underwent (EVRCP): 29 patients who developed CI-AKI (CI-AKI+ group) and 27 patients in whom the post-procedure period was uneventful. CI-AKI was defined as an increase in venous creatinine concentration of more than 25% by the end of 48 hours after EVRCP. During this phase of the study, the patient's medical history was analyzed - their anamnestic data, glycemic status, general urinalysis, kidneys, estimated glomerular filtration rate (eGFR) initially, 2,4,6,8 and 10 days after the procedure. Results The CI-AKI+ and CI-AKI- groups were compared in terms of clinical and anamnestic, hematological, urological data and the results of echocardiography and renal ultrasound with each other and with representatives of the CG. The CI-AKI+ and CI-AKI- groups did not differ in nosological distribution (Fig. 1): in both groups, half of the patients with EVRCP were performed due to the presence of coronary pathology (51.72% and 48.15%, respectively), the rest in patients it was comparable for CCI and CVD (27.59% and 20.69% in the CI-AKI+ group and 25.93% each in the CI-AKI- group). Conclusion Taking into account the OR of CI-AKI in patients with DM in the presence of identified predictors, a risk scale was developed. A risk score of 28 points or more demonstrates a predictive sensitivity in terms of the development of CI-AKI of 96.55% (p<0.001).