Abstract 13680: Impact of Estimated Glomerular Filtration Rate and Proteinuria on Contrast-induced Nephropathy in Patients With Cardiac Catheterization

Abstract

Background: Contrast induced nephropathy (CIN) has been a subject of concern to cardiologists in recent year because CIN is associated with increased morbidity, mortality, and healthcare expense. Incidence and risks of contrast induced nephropathy (CIN) after cardiac catheterization are not clear in Japan. Objective: The aim of this study is to investigate the pre-procedural predictors of CIN. Methods: This study, named the study for CIN after cardiac catheterization in Japan (the CINC-J study), is a multicenter cohort study, which examined 1021 patients undergoing cardiac catheterization from 29 hospitals in all over Japan. We divided into 4 groups on the basis of estimated glomerular filtration rate (eGFR: >60 ml•min-1•1.73m-2 = Normal, 45 to 60 = Mild, 30 to 45 = Moderate, <30 = Severe). CIN was defined as an increase in serum creatinine level of 0.5mg/dl or 25% from 48 to 72 hours after contrast-medium injection. Results: The incidence of CIN was significantly higher in patients with proteinuria than those without proteinuria (13.6% vs. 2.8%, p<0.001). In patients without proteinuria, the incidence of CIN was not increased with reducing eGFR, however, in patients with proteinuria, the incidence of CIN was significantly increased with reducing eGFR as shown in the figure. Multivariate-logistic-regression analysis revealed that proteinuria (hazard ratio=3.77; 95% CI: 1.54 to 9.10), contrast volume/eGFR (hazard ratio=1.29; 95% CI: 1.01 to 1.62), Ca antagonist (hazard ratio=3.46; 95% CI: 1.36 to 9.94) were independent predictors of CIN. Conclusions: Proteinuria is the strongest predictor for CIN after cardiac catheterization.