#2967 CALCULATION OF THE RISK OF CONSTRAST-INDUCED ACUTE KIDNEY DAMAGE IN THE CUTANEOUS CORONARY INTERVENTION IN PATIENTS WITH DIABETES MELLITUS

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 took place in two stages. 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. The first stage, a retrospective one, included a comparative analysis of two groups of diabetic patients who underwent an endovascular radiopaque procedure (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 EVRD. Results Based on the analysis, we developed a risk scale for the development of CI-AKI in patients with DM. In the process of compiling the scale, the value of RR for the development of CI-AKI in the presence of the corresponding factor, rounded to the nearest whole number, was used as risk coefficients. According to the developed scale, in the presence of a risk factor, the patient is assigned a certain score. The score determines the risk of CI-AKI. Conclusion Thus, the present study showed that in patients with DM, compared with healthy volunteers, there is a change in kidney function, which is more pronounced in individuals prone to the development of CI-AKI. Changes in the cellular and biochemical blood composition in patients with DM are characteristic of diabetic nephropathy and are also more pronounced in patients at risk of CI-AKI.