Contrast-induced nephropathy: the possibility of early diagnosis in patients with type 2 diabetes mellitus after primary percutaneous coronary interventions

Abstract

Aim. To study the possibilities of early diagnosis of contrast-induced nephropathy (CIN) after primary percutaneous coronary interventions (PCI) in patients with type 2 diabetes mellitus (DM) using biostarers: cystatin C, nephrine and lipocalin-2.
 Materials and methods. he study included 84 patients who received PCI for the first time. Before the PCI, the risk of CIN on the R. Mehran scale was assessed, and also modern biomarkers of renal damage were determined before and after the procedure for 3 days. All patients were divided into two groups: 1). patients with type 2 DM (n = 44 people); 2) patients without DM (n = 40 people). By sex, age, the duration of the disease group were comparable.
 Results. The parameters of the functional state of the kidney before and after PCI in patients with type 2 DM, taking into account the criteria of KDIGO (2012) and elevated levels of modern biomarkers, indicated the development of CIN. In the control group, this was observed in 35 of 40 (87.5%) patients. In both groups, there was an increase in serum creatinine levels of blood, urea, new biomarkers, and a decrease in GFR after administration of contrast agents. Normalization of only urea and blood creatinine against the background of adequate hydration was detected on day 2-3 after contrasting procedures. The GFR remained still reduced despite ongoing therapy.
 Conclusions. Cystatin C, nephrin, lipocalin 2 have high sensitivity and specificity. The determination within 3 days of these biomarkers allows us to objectively judge the dynamics of contrast-induced nephropathy in individuals with type 2 diabetes mellitus in surgical interventions on the coronary arteries with the introduction of contrast and the effectiveness of protective measures.