The early detection and prevention of contrast induced nephropathy post coronary intervention in catheterization unit

Abstract

BackgroundContrast induced nephropathy (CIN) which is following the administration of radiographic contrast media in coronary intervention results in increased morbidity and mortality. Several prophylactic methods were done to prevent CIN post coronary intervention. Aim of the workTo evaluate contrast media volume to creatinine clearance (V/CrCl) ratio for predicting (CIN) and to determine a safe contrast media volume to prevent CIN post Coronary interventions in catheterization unit. Patients and methodsThis study was carried out in ----- Cardiac Catheterization Unit and included 315 patients who underwent coronary intervention. Inclusion criteria: Coronary angiography, PCI,. Exclusion criteria: Acute renal failure, Dialysis- dependant chronic renal failure. Blood urea, serum creatinine and Creatinine clearance were measured and calculated for all patients in the day before coronary angiography and then daily after the procedure for three days after the procedure. ResultsThe patients were divided into four groups; Group I: 77 patients who have V/Cr.Cl <1. Group II:79 patients who have V/Cr.Cl (1.07–2.3).Group III: 78 patients who have V/Cr.Cl (2.3–3.31). Group IV: 80 patients who have V/Cr.Cl >3.31. The optimal cut off level for the V/CrCl ratio for predicting CIN was >2.8593 (85.3% sensitivity & 79.6% specificity) and is an independent risk factor of CIN. Conclusiona reduction in the contrast media volume to a V/CrCl ratio <2.85 is a new predictors for early diagnosis and prevention of CIN post cardiac catheterization in patients with relatively normal renal function.