Contrast-induced Nephropathy In Patients Research Articles

Letter: C-Reactive Protein/Albumin Ratio as a Novel Predictor of Contrast-Induced Nephropathy in Patients With Stable Angina Pectoris.

Letter: C-Reactive Protein/Albumin Ratio as a Novel Predictor of Contrast-Induced Nephropathy in Patients With Stable Angina Pectoris.

The predictive value of residual SYNTAX score and SYNTAX revascularization index for contrast-induced nephropathy in patients with ST-segment elevation myocardial infarction.

We aimed to evaluate the association of incomplete revascularization score and the treated coronary artery disease burden with the development of contrast-induced nephropathy (CIN) in patients with ST-segment elevation myocardial infarction (STEMI) who underwent primary percutaneous intervention. Incomplete revascularization score was expressed by the residual SYNTAX (SYNergy between percutaneous coronary intervention with TAXus and cardiac surgery) (rSS) and the treated coronary artery disease burden was expressed by the SYNTAX revascularization index (SRI). In our study, 604 sequential patients who underwent percutaneous coronary intervention diagnosed with STEMI between January 2018 and December 2021 were included. Patients were categorized into two groups; 'CIN (+)' who developed CIN and 'CIN (-)' who did not develop CIN. Baseline demographic, laboratory, echocardiographic, and angiographic data of the groups were compared. SYNTAX score I and II, rSS, and SRI were calculated. The diagnostic power of these angiographic parameters in the prediction of CIN was evaluated. Predictors for the development of CIN in STEMI patients were investigated. The mean age of the patients included in our study was 58.7 ± 12.4 years, and 79.9% of them were men. CIN was observed in 17.8% of study patients. The SYNTAX score [17.8 (11.4-24.2) vs. 15.1 (10.1-21.2); p = 0.008] and rSS [8.14 (3.9-116) vs. 4.2 (2.6-8.2); p < 0.001] were higher and SRI [56.2 ± 10.2 vs. 71.1 ± 13.6; p < 0.001] was lower in the CIN (+) group compared to the CIN (-) group. In predicting CIN, rSS was found to have significant diagnostic power at a cut-off value of 5.2, sensitivity of 81% and specificity of 69% [AUC (95% CI) = 0.752 (0.602-0.814); p < 0.001]. In logistic regression analysis, rSS [OR (95% CI) = 1.492 (1.124-1.884); p < 0.001] and SRI [OR (95% CI) = 1.055 (1.027-1.092); p < 0.001] were defined as independent predictors for the development of CIN. rSS and SRI are associated with CIN in STEMI patients. Although rSS is superior in predicting CIN, both angiographic scorings have significant diagnostic power. rSS and SRI are independent predictors for the development of CIN.

Inferior Vena Cava Collapsibility Index and the Risk of Contrast-Induced Nephropathy in Patients Undergoing Coronary Angiography

Introduction: The present study aims to investigate the association between contrast-induced nephropathy (CIN) and inferior vena cava collapsibility index (IVC-CI) measured via echocardiography to estimate intravascular volume. Patients and Methods: A total of 100 patients were referred to coronary angiography (CAG). On the day of admission, blood samples were collected, and an echocardiographic evaluation was performed to estimate IVC-CI immediately before CAG. IVC-CI ratios were stratified into three groups (low, mid, high) (&lt;50%, 50-75%, &gt;75%). Creatinine was assessed again at 48 hours following the CAG procedure. The difference between baseline serum creatinine and serum creatinine at 48 hours was calculated as ΔCrea while the difference in GFR was calculated as ΔGFR. Biochemical parameters and CIN ratios were compared between all groups. Results: There were no differences across the groups in terms of procedural characteristics, preprocedural lab parameters, and concomitant medication. ΔCreatinine, ΔGFR, and the incidence of CIN were significantly higher in the high IVC-CI group. Conclusion: Post-procedure incidence of CIN, ΔGFR, and Δcreatinine compared to the pre-procedure values were higher in the high IVC-CI group.

Frequency of Contrast-Induced Nephropathy in Patients Undergoing PCI

Background: Contrast-induced nephropathy (CIN) is accompanied by a considerable increase in illness and death following percutaneous coronary intervention (PCI). Aim: The present work aims to detect the frequencies of patients with different risk factors that affected how much with CIN Percutaneous coronary intervention. Methodology: This is a planned distinct study that included 200 patients that received PCI at the Punjab Institute of Cardiology in Punjab, Pakistan. Regarding the baseline values, a CIN was described as a 25 percent or 0.5 mg/dl increase in serum creatinine after 48 hours following PCI. Several reliable indicators of CIN were examined in this study like patient’s demographics (age and gender), Body mass index (kg/m2), Co-morbidities and Serological parameters as well as angiographic and practical characteristics of patients. Results: Out of 200 patients, (11%) developed contrast nephropathy and the (89%) didn’t. CIN patients were found to be older, more commonly males, more likely to have Diabetes mellitus, dyslipidemia as well as Hypertension, and higher levels of peak creatine kinase and LDL (mg/dl). In the CIN group, the causative artery was found in the left anterior descending artery more frequently and the patients (100%) in the CIN group who received contrast volume &gt; 100ml developed CIN more frequently, significantly than those without CIN (22.4%,) at p&lt; 0.001. Keywords: Percutaneous coronary intervention, Contrast-induced nephropathy, serum creatinine, diabetes, and hypertension.

Systemic immune inflammation index: is it a new marker for contrast-induced nephropathy?

Introduction: Worldwide, &amp;gt;200 million patients are affected by peripheral arterial disease (PAD) and endovascular interventional treatments are increasingly being applied. Contrast-induced nephropathy (CIN) is the third most common cause of renal failure in hospitals. However, factors such as renal vasoconstriction, decrease in renal blood flow, endothelial dysfunction, and oxidative stress have been suggested in the etiology of CIN. Studies are showing that inflammatory markers increase in CIN. Systemic immune inflammation index (SII), a newly defined parameter, is calculated by multiplying the platelet and lymphocyte counts and dividing by the neutrophil count. Studies are showing that this parameter influences prognosis in various cancer types. Considering that inflammation may play a role in CIN, we planned this study to investigate the role of SII in patients undergoing percutaneous peripheral vascular interventions. Material and Method: 300 patients who underwent percutaneous peripheral vascular interventions between August 2018-December 2021 due to peripheral arterial disease were included in the study. The data of the patients were scanned retrospectively from the patient files. The neutrophil-lymphocyte ratio (NLR) was calculated by dividing the neutrophil count by the lymphocyte count. SII was found by multiplying NLR with platelet count Results: Contrast-induced nephropathy developed in 41 (12.3%) patients. CIN(+) patients also, had higher CRP levels (5.1±0.7vs 2.4±0.4,P&amp;lt;0.05), NLR (4.07±1.07vs 2.65±0.84, P&amp;lt;.005), SII score (1778±627.57vs 867.14±491.88, P&amp;lt;.005.) the contrast media used was also higher in CIN(+) patients (176.19±48.44 vs 128.72±48.44;P&amp;lt;0.05) Multivariate logistic regression analysis demonstrated that a high SII score was an independent predictor of development of CIN (odds ratio [OR]: 1.002, 95% confidence interval [CI]: 1.001-1.002, P&amp;lt;.0005) together with high NLR (OR: 3.56, 95% CI: 1.905-6.675, P&amp;lt;.005) and CRP (OR: 1.002, 95% CI: 1.001-1.002, P&amp;lt;.005 Receiver operating characteristic curve analysis demonstrated that the best cutoff value of 1224 for SII to predict the development of CIN with 85% sensitivity and 72% specificity (area under ROC curve 0.904 [95% CI: 0.866-0.942], P&amp;lt;.005). Conclusion: Imbalance in inflammatory cells, the increase in neutrophils, and the decrease in lymphocytes play a role in developing kidney damage. Impaired immune functions due to lymphocytopenia contribute to the development of acute kidney injury. Oxidative stress exacerbates the inflammatory state by increasing inflammatory cell infiltration. AS a result, SII may be a powerful predictor of inflammation and can be used to determine the risk before interventional procedures.

Contrast Media Volume to Creatinine Clearance Ratio in Predicting Nephropathy in Patients Undergoing Percutaneous Coronary Intervention: A Systematic Review and Meta-Analysis.

The studies investigated the predictive value of the contrast media volume to creatinine clearance ratio (V/CrCl) for contrast-induced nephropathy (CIN) after a percutaneous coronary intervention (PCI) showed conflicting results and different cut-off values. The objective is to evaluate V/CrCl in the prediction of CIN after PCI. PubMed, Embase, and the Cochrane library were searched for eligible studies published from inception to November 2020. The optimal cut-off points of V/CrCl for predicting CIN were examined using odds ratios (ORs) and 95% confidence intervals (CIs). The random-effect model was used for analyses. Six studies (8 datasets, 16899 patients) were included. V/CrCl was associated with CIN (OR = 2.67, 95% CI: 1.88-3.78, P < .001; I2 = 79.3%, Pheterogeneity < .001). V/CrCl was associated with CIN in Asians (OR = 2.13, 95% CI: 1.52-2.98, P = .022; I2 = 68.8%, Pheterogeneity < .001) and Europeans (OR = 3.87, 95% CI: 1.77-8.45, P < .001; I2 = 85.1%, Pheterogeneity = .001). The association between V/CrCl and CIN was observed in the prospective cohort studies (OR = 2.16, 95% CI: 1.42-3.29, P = .009; I2 = 78.9%, Pheterogeneity < .001) and retrospective cohort studies (OR = 3.31, 95% CI: 1.82-6.02, P < .001; I2 = 80.6%, Pheterogeneity < .001). The sensitivity analysis showed the results were robust. V/CrCl is independently associated with an increased risk of CIN. V/CrCl could be considered a reliable predictor for the development of CIN in patients undergoing PCI.

Microalbuminuria predicts contrast-induced nephropathy in patients with acute coronary syndrome

Microalbuminuria predicts contrast-induced nephropathy in patients with acute coronary syndrome

Effect of Remote Ischemic Preconditioning on the Incidence of Contrast-Induced Nephropathy in Patients Undergoing Endovascular Aneurysm Repair (Remote Ischemic Preconditioning–Endovascular Aneurysm Repair Study)

Contrast-induced nephropathy (CIN) is a major inconvenience in the use of iodinated contrast media (ICM) and it is associated with a significant increase in morbidity and mortality and cost of hospitalization. Remote ischemic preconditioning (RIPC) is a noninvasive and cost-effective tissue protection technique that has showed to be beneficial in decreasing renal insult in patients receiving intravascular contrast. The primary outcome of this study is to evaluate the impact of RIPC on the incidence of CIN in patients undergoing endovascular aneurysm repair. Patients suffering from aortic aneurysm were recruited prior to the administration of ICM. Randomization was used to assign patients into the control/RIPC groups. Biochemical parameters determined renal function before and after surgery in immediate (24-72hr) and at 30days of follow-up. Of the 120 patients included in the study, 98,3% were male. Mean age was 73years (range: 56-87 years). Diabetes and chronic renal failure (considering estimated glomerular filtration [eGFR] <60) was present prior to administration of ICM in 29.16% and 38.33%, respectively. RIPC was applied in 50% (n=60) of the patients. A total of 24.17% developed CIN regardless of fluidotherapy, RIPC, and other protective strategies. RIPC did not influence outcomes in terms of incidence on CIN, serum creatinine, urea, eGFR, or microalbuminuria in immediate postoperative period. However, the group of RIPC patients showed a statistically significant benefit in renal function in terms of serum creatinine (1.46±0.3 vs. 1.03±0.5; P<0.001), urea (61.06±27.5mg/dL vs. 43.78±12.9mg/dL; P=0.003), and an increase in eGFR (56.37±23.4mL/min/1.73m2 vs. 72.85±17.7mL/min/1.73m2; P=0.004) at 30days of follow-up. RIPC seems to be a reasonable, effective, and low-cost technique to alleviate effects of ICM on the renal parenchyma in endovascular aneurysm repair procedures during short-term postoperative period.

Abstract No. 287 An interpretable machine-learning-based risk model of contrast-induced nephropathy in patients undergoing lower-extremity endovascular interventions

Identification of patient cohorts at higher risk of contrast-induced nephropathy (CIN) may allow targeted interventions to reduce the incidence of renal injury, a postprocedural complication which may prolong hospital stay and contribute to increased morbidity and mortality. We aimed to develop an interpretable machine learning model to stratify individual risk for acute renal failure in patients undergoing lower extremity endovascular interventions for peripheral artery disease (PAD).

Systematic review and meta-analysis of prophylaxis use with intravenous contrast exposure to prevent contrast-induced nephropathy

PurposeIodinated radiographic contrast media has been associated with an acute deterioration in renal function, termed contrast induced nephropathy (CIN). This review aims to establish the efficacy of prophylaxis interventions used in adult patients prior to intravenous exposure to iodinated contrast to reduce the risk of CIN. MethodsAn electronic search for published peer-reviewed articles was performed, supplemented with manual review of references from previous systematic reviews and the National Institute for Health and Care Excellence guidelines. Risk of bias was assessed using the Cochrane Collaboration’s tool for assessing risk of bias. Random-effect meta-analyses were used to assess CIN incidence, need for kidney replacement therapy (KRT), mortality, fluid overload and persistent kidney dysfunction. Results22 studies assessing a range of interventions were included in the qualitative analysis. The incidence of CIN was reduced by the use of N-acetylcysteine compared to a control group of saline (risk difference = -0.07, 95% CI −0.13 to −0.01) but not by sodium bicarbonate compared to control group of saline (risk difference = -0.02, 95% CI −0.04 to 0.01). Published studies give no indication that prophylactic interventions have significant impact on the need for KRT, mortality or persistent renal impairment. ConclusionEvidence for prophylaxis against CIN in patients receiving intravenous iodinated contrast is limited. There was an association with the use of NAC with reduced incidence of CIN following intravenous contrast but there was no impact on other clinical outcomes assessed. The clinical significance of these findings remains unclear and further research focusing on these clinical outcomes is required.

C-Reactive Protein/Albumin Ratio as a Novel Predictor of Contrast Induced Nephropathy in Patients With Stable Angina Pectoris.

The relationship between C-reactive protein (CRP) to albumin ratio (CAR) and contrast-induced nephropathy (CIN) in patients with acute coronary syndrome has been reported. However, the relevance of CAR in patients with stable angina pectoris (SAP) has not been clarified. We hypothesized that CAR might predict the development of CIN in patients with SAP undergoing coronary angiography (CAG). Patients (n = 554) with SAP who underwent CAG were included in the study. CIN was defined as a ≥25% increase in serum creatinine compared with baseline value within 72h of CAG. Participants were divided into two groups: CIN (n = 87) and non-CIN (n = 467). Age, CRP, CAR, mean corpuscular volume (MCV), urea, uric acid, contrast medium volume, the percent of percutaneous coronary intervention were significantly greater, whereas albumin and high-density lipoprotein were significantly lower in the CIN group than non-CIN group (p < .05, for all). Multivariate analysis showed that CAR was the only independent predictor for CIN (odds ratio = 7.065, 95% confidence interval (CI); 3.279-15.221, p < .001). Receiver operating characteristic ROC analysis showed that a CAR ≥ 0.1164 could predict CIN (sensitivity of 71% and specificity of 72%; area under curve = 0.736; 95% CI: 0.677-0.795, p < .001). CAR was significantly greater in patients who developed CIN and this independently predicted CIN.

Evaluating the Effectiveness of Pretreatment With Intravenous Fluid in Reducing the Risk of Developing Contrast-Induced Nephropathy: A Systematic Review and Meta-Analysis.

Contrast media administration to patients during cardiac events increases the risk of developing contrast-induced nephropathy (CIN). CIN is among some complications usually associated with the percutaneous coronary intervention and may result in acute renal failure. Several risk factors are associated with CIN. These risk factors include; age (elderly patients), pre-existing renal impairment, diabetes mellitus, and the use of high osmolar contrast media. Studies have shown that several measures such as using low osmolar contrast media, N-acetylcysteine, intravenous sodium bicarbonate, and hydration through oral or intravenous fluid administration play a significant role in CIN incidence reduction. Hydration using intravenous fluid, especially saline solution, has been critical in preventing CIN. Prehydration using the intravenous fluid before contrast media administration is vital.A systematic literature search with meta-analysis for relevant and original articles was carried out from 2000 to 2022 on databases such as PubMed, Cochrane Library, Google Scholar, ScienceDirect, Web of Science, and Embase. The search on the databases was based on various keywords related to intravenous fluid and CIN. The studies that met the inclusion criteria were critically analyzed, and data such as study design, interventions, participants, and outcomes of the research were retrieved.Out of the 784 results yielded during the initial search, ten articles met the eligibility criteria and were included in the study. The data analysis obtained from the included studies showed that pretreatment using intravenous fluid has conflicting results. Some studies showed that hydrating patients using intravenous fluid before contrast media administration significantly reduces the risk of CIN. In contrast, others claimed that intravenous fluid has minimal impact on preventing CIN.Despite the different investigations conducted on CIN, it remains insufficiently understood. From the analysis, most of the studies support that intravenous fluid administration decreases the occurrence of CIN in patients that receive contrast media. The analysis also has established that oral hydration is similar to intravenous fluid administration in reducing CIN incidence.

H2FPEF Score and Contrast-Induced Nephropathy in Patients With Acute Coronary Syndrome Undergoing Percutaneous Coronary Intervention.

Contrast-induced nephropathy (CIN) is one of the most common complications associated with coronary angiography and percutaneous coronary intervention (PCI). This study evaluated the relationship between the H2FPEF (obesity (H), hypertension(H), atrial fibrillation (F), pulmonary hypertension (P), an age >60years (E), and E/e' > 9 (F)) score which is used to diagnose heart failure with preserved ejection fraction and CIN. Patients (n = 1346) who underwent PCI for acute coronary syndrome (ACS) between December 2018 and January 2021 were retrospectively included. Contrast-induced nephropathy patients had significantly higher H2FPEF scores (4.10 ± 1.92 vs 2.28 ± 1.56, P < .001). In addition, the H2FPEF score was found to be an independent risk factor for the development of CIN (Odd Ratio 1.633 95% CI (1.473-1.811), P < .001) together with age, diabetes mellitus, systolic pulmonary arterial pressure, and left anterior descending as an infarct-related artery. According to point biserial correlation analysis, CIN and H2FPEF score have a strong correlation (rpb = .376, P < .001). The receiver operating characteristic curve showed the optimal cutoff value of the H2FPEF score to predict the development of CIN was 2.5, with 79.8% sensitivity and 64.1% specificity. In conclusion, the H2FPEF score may predict the development of CIN in patients presenting with ACS and undergoing PCI.

Serum Uric Acid to Albumin Ratio Can Predict Contrast-Induced Nephropathy in ST-Elevation Myocardial Infarction Patients Undergoing Primary Percutaneous Coronary Intervention.

Contrast-induced nephropathy (CIN) is one of the common complication of ST-elevation myocardial infarction (STEMI) following primary percutaneous coronary intervention (pPCI). Serum uric acid to albumin ratio (UAR) is a novel marker, which is associated with acute kidney injury in intensive care unit patients. We investigated the predictive value of UAR for the development of CIN in STEMI patients (n = 1379) after pPCI. The diagnosis of CIN was made based on an increase of basal creatinine levels >.5mg/dL or 25% within 72 h after pPCI; 128 patients were in the CIN (+) group and 1251 patients were in the CIN (-) group. CIN (+) patients had higher serum uric acid (SUA), UAR, and lower albumin levels than CIN (-) patients. Age, diabetes, hypertension, hemoglobin, glucose at admission, basal creatinine, peak troponin I, total bilirubin, contrast volume/glomerular filtration rate, and UAR were independent predictors of CIN. A cutoff value of 1.62 for UAR detected CIN development with a sensitivity of 54% and specificity of 87.4%, and the discrimination ability of UAR was better than that of SUA or albumin. In conclusion, UAR was an independent predictor of the development of CIN.

Changing serum creatinine in the detection of acute renal failure and recovery following radiocontrast studies among acutely ill inpatients: Reviewing insights regarding renal functional reserve gained by large-data analysis

A rise in serum creatinine (SCr) is widely used for the detection and definition of evolving acute kidney injury (AKI). Yet, it takes time for SCr to re-adjust in response to changes in glomerular filtration rate (GFR), and subtle transient changes in GFR may remain concealed. Additionally, it cannot differentiate altered glomerular hemodynamics and pre-renal failure from true renal tissue injury, necessitating additional clinical and laboratory diagnostic tools.While these features limit the usefulness of SCr and subsequently estimated GFR (eGFR) at a single time point for the individual patient, their overall pattern of changes along time in a large cohort of hospitalized patients may provide a powerful perspective regarding the detection and assessment of shifting kidney function in this population. Herein we review our experience running large data analyses, evaluating patterns of day-to-day changes in SCr among inpatients, occurring around the exposure to iodinated radiocontrast agents. These large data evaluations helped substantiating the existence of contrast-induced nephropathy in patients with advanced renal failure, underscoring the impact of predisposing and confounding factors. It also provides novel insights regarding a phenomenon of "acute kidney functional recovery” (AKR), and illustrate that the incidence of AKI and AKR along the scale of baseline kidney function co-associates and is inversely proportional to kidney function. This can be attributed to renal functional reserve, which serves as a buffer for up-and-down changes in GFR, forming the physiologic explanation for concealed subclinical AKI.

Iopromide and Iodixanol in the Development of Postoperative Contrast Nephropathy in Patients with Renal Insufficiency: A Meta-Analysis.

In order to compare the effects of iopromide and isoxazole on postoperative contrast-induced nephropathy in patients with renal insufficiency, the paper searches for randomized controlled trials and retrospective cohort studies comparing the effects of iopromide and iodixanol on renal function in patients with renal insufficiency after surgery. The data are extracted from eligible studies. We tried to assess the incidence of contrast-agent nephropathy, preoperative and postoperative serum creatinine indicators, and mortality. This paper includes 8 studies with a total of 1243 patients. The incidence of contrast-induced nephropathy in the iopromide group is higher than that in the iodixanol group, and there is no significant difference between the two groups in postoperative mortality and preoperative serum creatinine expression. Sensitivity analysis and funnel chart show that our research is robust and has low publication bias. Our research shows that in patients with renal insufficiency, the incidence of contrast-medium nephropathy in the iopromide group is higher than that in the iodixanol group. Iodixanol is safer and has less effect on patients' serum creatinine levels.

VALIDITY OF MEHRAN RISK SCORE FOR PREDICTING CONTRAST INDUCED NEPHROPATHY IN MODERN PRIMARY PERCUTANEOUS CORONARY INTERVENTIONS ERA

Objectives: Contrast induced nephropathy (CIN) is a common complication and found to be associated with increased morbidity and mortality after primary percutaneous coronary intervention (PCI). The objective of this study was to validate the Mehran Risk Score (MRS) for the risk stratification of CIN in patients undergone primary PCI. Methodology: A cohort of consecutive patients undergone primary PCI at a tertiary care cardiac center were included for this study. Patients in Killip class IV at presentation, patents history of any PCI, and chronic kidney diseases were excluded from this study. MRS was calculated at baseline and post procedure serum creatinine level increase of either 25% or 0.5 mg/dL was taken as CIN. Results: A total of 547 patients were included, of which 79.3%(434) were male. CIN after primary PCI was observed in 62(11.3%) patients. The area under the curve (AUC) for the MRS was 0.712 [0.641 to 0.783]. Cut-off value of ≥6.5 had sensitivity of 61.3% [48.1%-73.4%] with positive predictive value of 21.2% [17.5%-25.6%] and specificity of 70.9% [66.7%-74.9%] with negative predictive value of 93.5% [91.3%-95.2%]. MRS ≥6.5 was found to be an independent predictor on multivariable analysis with adjusted odds ratios (OR) of 3.86 [2.23-6.68] along with multi-vessel diseases with OR of 2.31 [1.27-4.19]. Conclusion: MRS has shown to have a good discriminating power. However low positive predictive value of the optimal cutoff value of ≥6.5 for prediction of CIN suggests need of modification to the MRS to improve its clinical utility in the modern era of primary PCI.

PREDICTIVE VALUE OF C-REACTIVE PROTEIN/ALBUMİN RATIO IN THE DEVELOPMENT OF CONTRAST-INDUCED NEPHROPATHY IN PATIENTS WITH ACUTE ISCHEMIC STROKE TREATED PERCUTANEOUSLY

Contrast induced nephropathy (CIN) is known to play an important role in acute kidney injury. The purpose of this study was to determine the predictive effect of the CRP/albumin ratio (CAR) in the detection of CIN in patients with acute ischemic stroke (AIS) treated percutaneously. A total of 148 acute stroke patients treated percutaneously were included in the study. In the study population, groups were determined according to the development of CIN. The CAR value was calculated by dividing the CRP value by the albumin value. CIN developed in 26 (17%) patients. DM (p=0.031) and HT (p=0.014) diseases were observed at higher rate in the CIN group. Glucose (p&amp;lt;0.001), contrast amount (p&amp;lt;0.001), WBC (p=0.020), NIHSS0 score (p=0.001), and CAR (p&amp;lt;0.001) were higher in the CIN (+) group compared to the CIN (-) group. A cutoff point of 0.393 for CAR was identified with 80.7% sensitivity and 92.6% specificity to predict CIN. The CAR was found to be significantly higher in CIN patients and was also identified as an independent predictor of the development of CIN.

Relationship between basal liver function test levels and contrast-induced nephropathy in patients undergoing coronary angiography

Relationship between basal liver function test levels and contrast-induced nephropathy in patients undergoing coronary angiography

A Novel Predictor of Contrast-Induced Nephropathy in Patients With Carotid Artery Disease; the Systemic Immune Inflammation Index.

Contrast-induced nephropathy (CIN) is associated with increased mortality and morbidity. The present study investigated the role of systemic immune inflammation index (SII) in predicting the risk of developing CIN after carotid artery angiography (CAAG). This study included 262 patients who underwent CAAG for symptomatic carotid artery stenosis (CAS). Simultaneous carotid stenting was applied to 232 of these patients. CIN was defined as an increase in serum creatinine level ≥.5mg/dL or ≥25% above baseline within 72 hours after the procedure. The SII score was calculated as platelet × neutrophil/lymphocyte counts. Patients who developed CIN, had higher glucose (P = .009), total cholesterol (P < .001), low density lipoprotein cholesterol (<.001), and high sensitivity C-reactive protein (P = .001) levels, as well as greater neutrophil counts (P < .001), platelet counts (P < .001), neutrophil-lymphocyte ratio (P < .001), and SII score (P < .001) than those who did not develop CIN. The Receiver Operating Characteristic analysis showed that at a cutoff of 519.9, the SII exhibited 80% sensitivity and 64% specificity for detecting CIN. SII levels on admission were independently associated with CIN development after CAAG in patients with CAS.