Fórmula de CKD‐EPI versus Cockcroft‐Gault na predição de nefropatia induzida por contraste após intervenção coronária percutânea, em pacientes sem disfunção renal significativa

Abstract

IntroductionIndividuals with glomerular filtration rate (GFR) ≥60 ml/min/1.73 m2 estimated by the Cockcroft‐Gault formula (CG) who undergo percutaneous coronary intervention (PCI) frequently develop contrast‐induced nephropathy (CIN). This study aimed to assess whether individuals with significant renal impairment assessed by the Chronic Kidney Disease Epidemiology Collaboration (CKD‐EPI) formula, but not by CG, more often develop CIN following PCI than those without renal impairment by either formula. MethodsIn this cross‐sectional study analyzing patients with baseline CG GFR ≥60 ml/min/1.73 m2 before PCI, subjects were divided into two groups according to CIN occurrence. Baseline CKD‐EPI GFR was calculated for all patients. ResultsWe analyzed 140 patients. Baseline GFR was 87.5±21.3 and 77.1±15.0 ml/min/1.73 m2 for CG and CKD‐EPI, respectively. CIN occurred in 84.6% of individuals with baseline CKD‐EPI GFR <60 ml/min/1.73 m2 vs. 51.1% of those without. Males and those with higher body mass index were more likely to present baseline CKD‐EPI GFR <60 ml/min/1.73 m2 (p=0.021). Non‐ionic contrast agent use and baseline CKD‐EPI GFR ≥60 ml/min/1.73 m2 were protective factors against CIN. Greater amounts of contrast agent and acute coronary syndrome were associated with higher CIN risk. In subjects with serum creatinine <1.0 mg/dl, GFR was more likely to be overestimated by CG, but not by CKD‐EPI (sensitivity 100.0%; specificity 52.0%). ConclusionIn patients undergoing PCI without renal dysfunction by CG, a finding of CKD‐EPI GFR <60 ml/ min/1.73 m2 was associated with a higher probability of CIN, especially among men and those with higher body mass index.