Study of Risk Factors and Applicability of Mehran Risk Score in Predicting Contrast Induced Nephropathy in Patients Undergoing Percutaneous Coronary Intervention Patients – A Prospective Observational Cohort Study

Abstract

Background: Contrast induced nephropathy (CIN) is a grave but underdiagnosed complication of percutaneous coronary intervention that is associated with increased in-hospital morbidity and mortality. Our aim was to study the incidence, risk factors of CIN and applicability of Mehran risk score (MRS) in Indian population. Methods: A total number of 432 patients were enrolled in the study. Patients of age ≥ 18 years with known CAD, ACS who underwent PCI were included. Patients were followed for development of CIN. Results: Mean eGFR of 88.4 + 30.65 ml/min/1.73 m2 and mean contrast volume usage of 122.8 + 41.9 ml. 64 patients (14.8%) developed CIN. On univariate analysis, age (p 0.435), gender (0.125), hypertension (0.679), diabetes (0.177), contrast volume (0.155) were not associated with development of CIN whereas, smoking (0.021), hypotension (<0.001), heart failure (<0.001), anemia (0.001) and median eGFR (p < 0.001) were significantly associated with development of CIN. The incidence of CIN was 2.7 fold higher (OR : 2.68, 95% CI : 1.299-5.540, p = 0.008) in the intermediate group (MRS 6-10), 5.4 fold higher (OR : 5.403, 95% CI : 2.249-12.978, p <0.001) in the high risk group (MRS 11-15) and 51 fold higher (OR : 51.059, 95% CI : 18.195-143.278, p <0.001) in the very high risk groups (MRS > 16) when compared to the low risk group (MRS < 5) respectively. Conclusions: The incidence of CIN in the very high risk group (MRS > 16) was substantially higher in our study (77.8 %) as compared to same group in Mehran study (57.3 %).