#731 The role of diabetes mellitus in the development of contrast-induced nephropathy in patients during x-ray endovascular procedures

Abstract

Abstract Background and Aims To identify the role of diabetes mellitus in the development of contrast-induced nephropathy (CIN) in patients during X-ray endovascular procedures (REP). Method The study included 150 patients with coronary artery disease who underwent X-ray endovascular procedures (REP) using the contrast agent unihexone. The mean age of the patients was 55.69±1.27 years, including 83 men and 67 women, which accounted for 55.3% and 44.7% of the total number of patients, respectively. Diabetes mellitus was detected in 73 patients (49%). To isolate patients whose REP in the postoperative period was complicated by CIN on days 1, 2, 3, 5, 7, and 10, dynamic determination of serum creatinine concentration was carried out with glomerular filtration rate calculation. According to the results, all patients were divided into 2 groups: patients with uncomplicated postoperative REP (CIN- group, 99 patients, 66%) and patients who developed contrast-induced nephropathy (CIN+ group, 51 patients, 34%). As a control group, 20 healthy volunteers were examined. The validity of intergroup comparisons was carried out using the Student's test for paired and unpaired differences. Results In the course of the study, it was revealed that in the group of patients who developed CIN, there were significantly more people who developed CIN against the background of type II diabetes mellitus (p < 0.05), which is probably explained by their tendency to develop diabetic microangiopathy, one of the variants of which is nephropathy. The study of glycemic features in patients with CIN included in the study demonstrated that among patients with diabetes who developed CIN, the level of glycemia was significantly higher than in patients with uncomplicated course of REP (p < 0.05 for fasting and p < 0.001 for postprandial glycemia), that is, the higher level of glycemia in patients with CIN of the CINgroup is explained not only by the large number of patients with diabetes, but also by the large number of patients with diabetes. but also its less control. In parallel with higher glycemia, patients with diabetes of the CIN+ group were also distinguished by more pronounced uricemia (p < 0.01). The increased relative density of urine in patients with diabetes of the CIN+ group compared to patients with CI- (p < 0.05) is explained by the osmotic effect of glycosuria. Conclusion Thus, the presence of background DM, and especially its decompensation, is a risk factor for the development of CIN after REP.