Predictive significance of the neutrophil percentage-to-albumin ratio in post-percutaneous coronary intervention contrast-induced nephropathy among type 2 diabetes mellitus patients with chronic coronary syndrome.

Background: Contrast-enhanced imaging is important for diagnosing critical conditions in hospitalized patients. Iodinated contrast media are important for diagnostic imaging, but it also carry risks of adverse reactions. Most studies examined the outpatients, but we focused on hospitalized patients who are already suffering from some disease or illness and staying in the hospital. These patients are already having health problems and need urgent scan. We should study on how risky contrast can be for already suffering patients specifically. Objective: To find out how commonly adverse reactions can happen in hospitalized patients who are getting contrast for imaging and to see if kidney disease can make these contrast reactions worse. Methodology: We studied 114 patients who underwent contrast imaging. We noted the basics which includes age, sex, and the conditions or diseases they had. Then followed up who reacted and how severely reacted to contrast. Furthermore, we added crosstabs to check if kidney disease and reactions are aligned. Results: Mostly older patients which include 55.3% were aged 50–65 years, 41.2% were aged 66–80 years. 52.6% were male and 47.4% were female. Hypertension was present in 43.9%, kidney disease in 27.2%, cancer in 7.9%. Overall reaction rate was 29.8%, 70.2% had no reaction, 21.1% showed mild, 6.1% showed moderate, 2.6% showed severe reaction. The critical finding was all severe reactions occurred exclusively in kidney disease patients 9.7% of that subgroup versus 0% with healthy kidneys. Patients with kidney disease showed higher reaction rates: 64.5% reacted while only 16.9% of those with normal kidneys. Cancer clustered unexpectedly in kidney patients (25.8% versus 1.2%). Conclusion: This study gives us the hospital patient perspective that was not looked at before. Kidney disease is the reason why some hospitalized patients have really bad reactions to contrast. So, it is really important that we check the kidneys of all inpatients and take care with the people who have kidney disease to prevent any adverse reaction. Another reason is that the patients are already having medications which are affecting their kidneys.

Abstract Background: Contrast-induced nephropathy (CIN) is a significant cause of acute kidney injury, particularly in patients with pre-existing renal issues. Its pathophysiology involves oxidative stress. Allopurinol, a xanthine oxidase inhibitor, may protect the kidneys by mitigating this damage. This meta-analysis evaluates the efficacy of allopurinol with intravenous hydration versus intravenous hydration alone in preventing CIN. Methods: Following PRISMA guidelines, PubMed, Google Scholar, Cochrane CENTRAL, and Herdin databases were searched for randomized controlled trials comparing allopurinol with intravenous hydration to intravenous hydration alone in patients undergoing coronary procedures. Primary outcome was CIN incidence, with secondary outcomes including serum creatinine, uric acid, BUN, and eGFR changes. Risk of bias was assessed using Cochrane's tool, and analysis used a random effects model. Results: Analysis of five randomized controlled trials showed that allopurinol significantly reduced the incidence of contrast-induced nephropathy (CIN) by 47% (95% CI 0.32–0.87, p = 0.01). This effect remained consistent even after sensitivity analysis, showing a 58% reduction (RR = 0.42, 95% CI 0.22–0.81, p = 0.01). Allopurinol also significantly decreased serum creatinine (MD = -0.08, 95% CI -0.11, -0.04, p = 0.0001). However, the results for uric acid were inconsistent due to high heterogeneity, and there was limited data on BUN and eGFR, which prevented definitive conclusions about these outcomes. Conclusion: Allopurinol and hydration effectively reduce the risk of CIN, suggesting improved renal outcomes, particularly for high-risk patients in resource-limited settings where allopurinol is a cost-effective and accessible option. Further research is warranted.

BackgroundThis study was designed to investigate the impact of the serum free triiodothyronine to free thyroxine ratio (FT3/FT4) on both the incidence and long-term prognosis of contrast-induced nephropathy (CIN) following elective percutaneous coronary intervention (PCI).MethodsThis retrospective study was conducted among patients who underwent elective PCI at the Second Hospital of Tianjin Medical University from January 1, 2019, to March 31, 2022. The diagnosis of CIN was established when serum creatinine (SCr) level increased by more than 44.2 mol/L (0.5 mg/dL) or 25% compared to baseline within 48–72 h post-PCI. Logistic regression analysis was employed to identify independent predictors of CIN. Cox regression and survival analysis were utilized to assess factors influencing all-cause and cardiovascular mortality. Furthermore, the correlation between FT3/FT4 and the occurrence of CIN was examined via restricted cubic spline (RCS) analysis.ResultsThe study encompassed a cohort of 1,390 patients, out of whom 173 (12.4%) experienced CINs. Patients diagnosed with CIN exhibited advanced age, a greater prevalence of acute myocardial infarction (AMI) and chronic renal dysfunction, along with a lower level of FT3/FT4 (all P < 0.001). Stratification based on FT3/FT4 quartile resulted in four distinct patient groups. Notably, significant distinctions emerged among the groups in terms of CIN occurrence, all-cause mortality, cardiovascular mortality. RCS analysis depicted a J-shaped relationship between FT3/FT4 levels and the incidence of CIN. The curve showed an inflection point at an FT3/FT4 ratio of approximately 0.306. CIN risk initially decreases and then increases with the increase of FT3/FT4 ratio. Several factors were identified as risk factors for all-cause mortality, including age, myocardial infarction, LVEDD, SCr before PCI, diuretic usage, left main coronary artery disease, and left circumflex artery disease. Conversely, diastolic blood pressure, serum albumin, post ballooning, statin usage, and FT3/FT4 demonstrated protective effects.ConclusionThe FT3/FT4 level was significantly associated with both incidence of CIN and long-term all-cause mortality in patients undergoing elective PCI.Supplementary InformationThe online version contains supplementary material available at 10.1186/s12872-026-05568-4.

Background and Objectives: This study aimed to evaluate the predictive value of the Aggregate Index of Systemic Inflammation (AISI) for contrast-induced nephropathy (CIN) development in elderly patients with acute coronary syndrome (ACS) undergoing PCI. Materials and Methods: The study included consecutive patients aged ≥65 years who underwent PCI for ACS between January 2022 and January 2024. The primary endpoint was the occurrence of CIN, defined as an increase in serum creatinine ≥0.5 mg/dL or ≥25% from baseline within 48-72 h after PCI. The AISI was calculated for each patient. Results: A total of 437 patients (mean age 73.7 ± 7.2 years, 64.5% male) were included. The overall incidence of CIN was 25.6%. Patients who developed CIN were older, more frequently female, and had lower left ventricular ejection fraction and albumin but higher SYNTAX I scores and baseline creatinine (all p < 0.001). AISI demonstrated a significant predictive accuracy for CIN (AUC: 0.709, 95% CI: 0.647-0.771, p < 0.001), which was statistically comparable to the Mehran score (AUC: 0.744, p = 0.095). In multivariable analysis, AISI emerged as a strong independent predictor of CIN (OR: 1.345, 95% CI: 1.123-1.437, p < 0.001), alongside SYNTAX I scores, baseline creatinine, and serum albumin. Notably, AISI retained its independent predictive power even when adjusted for the Mehran score (OR: 1.276, p < 0.001). Conclusions: AISI independently predicts CIN in elderly patients with ACS undergoing PCI. Its superior discriminative ability compared with single hematologic markers highlights the importance of systemic inflammatory burden in CIN pathogenesis. Incorporating AISI into pre-procedural assessment may improve risk stratification and preventive management in this high-risk population.

Background Although energy-integrating detector (EID) CT remains the standard in diagnosing and monitoring lung cancer, it has limitations compared with photon-counting CT (PCCT). However, the role of low-dose PCCT in evaluating lung cancer remains unexplored. Purpose To compare the diagnostic quality of chest CT images from PCCT with a low radiation dose and a low injection rate, volume, and concentration of contrast agent (hereafter, a "quadruple-low protocol") with that of EID CT in patients with lung cancer. Materials and Methods This retrospective study included patients with lung cancer undergoing PCCT or EID CT between July 2024 and September 2024. Patients underwent PCCT with the low radiation dose plus reduced contrast agent protocol (quadruple-low protocol: 2.0 mL/sec injection rate, 1.0 mL/kg of 320 mg of iodine per milliliter) and EID CT with a conventional protocol. Two radiologists independently evaluated the subjective image quality and lesion imaging features. Lesion and parenchymal metrics (attenuation, signal-to-noise ratio [SNR], and contrast-to-noise ratio [CNR]) were also assessed. Data were compared using the Student t test, Mann-Whitney U test, or multivariable regression. Sensitivity analysis was performed using propensity score matching. Results Among 425 participants (mean age, 61 years ± 9.5 [SD]; 273 men), PCCT reduced radiation dose by 55% (mean effective dose, 3.49 mSv ± 0.91 vs 7.82 mSv ± 2.15; P < .001) while lowering contrast agent injection rate, volume, and concentration by 33% (P < .001), 22% (P < .001), and 9% (P < .001), respectively. PCCT reduced the incidence of contrast-induced nephropathy (CIN) compared with EID CT (0% [0 of 120] vs 7.9% [24 of 305], P = .02). PCCT also exhibited higher objective SNR and CNR in lung lesions and parenchyma, with superior subjective image quality scores and increased diagnostic confidence for imaging features (all adjusted P < .001). Results remained consistent in sensitivity analysis. Conclusion Compared with EID CT, PCCT with a quadruple-low protocol reduced the incidence of CIN and enhanced image quality and diagnostic confidence in imaging features in patients with lung cancer. © RSNA, 2026 Supplemental material is available for this article.

Background/Objectives: Contrast-induced nephropathy (CIN) is a common iatrogenic or medically induced condition among patients who receive intravenous infusion of iodinated contrast media that can cause renal insufficiency, raise the cost of care, and increase mortality risk. This study evaluated the incidence of CIN and predictors of renal function among cancer patients receiving contrast-enhanced computed tomography (CECT). Methods: A prospective, single-center longitudinal study was conducted at King Abdul-Aziz Medical City’s (Jeddah) medical imaging department from December 2021 to December 2023. Convenience sampling was used to select patients who were exposed to CECT based on data filled in the electronic medical record during the study period. Results: The final sample constituted 80 patients (47.71% attrition, mean age = 55.5 years, 58.75% male). The high attrition rate was associated with participants with incomplete records, those who were lost to follow-up, and those whose follow-up Scr was collected after 72 h from CECT administration. There was no statistically significant change in Scr following contrast exposure (mean increase 0.9 µmol/L; paired t = 1.41, p = 0.162; Wilcoxon p = 0.326). The incidence of CIN was 3.75% (3 of 80 patients; 95% confidence intervals (CI), 1.28–10.39%). Regression analysis showed no statistically significant associations between the percentage change in Scr and age, sex, baseline creatinine, or eGFR category (model R2 = 0.07). No clinically meaningful predictors of CIN were identified. Conclusions: The incidence of CIN in this study’s cohort of low-risk cancer patients undergoing CECT was low, and contrast exposure did not produce significant short-term changes in renal function. These findings support the safety of modern contrast agents in oncology imaging, but multi-center studies with larger samples and more robust methods are warranted to refine CIN risk assessment in cancer patients undergoing CECT.

Differential effects of pre-procedural atorvastatin versus rosuvastatin on hematologic and inflammatory markers in patients with ST-elevation myocardial infarction undergoing primary percutaneous coronary intervention: A randomized controlled trial.

The Fibrosis-4 (FIB-4) index is used to assess the risk of liver fibrosis but is also a cardiovascular risk factor. To analyze the impact of FIB-4 on the incidence of contrast-induced nephropathy (CIN) and clinical outcomes in acute coronary syndrome (ACS). A retrospective study included 1465 patients with ACS who underwent coronary angiography or percutaneous coronary intervention (PCI) and were stratified according to FIB-4 levels: < 1.45, 1.45-3.25, and ≥ 3.25. The subgroup with FIB-4 index ≥ 3.25 showed the highest incidence of CIN (4.8% vs. 5.9% vs. 10.0%; p = 0.018), as well as the highest mortality rates at 30 days (1.9% vs. 1.8% vs. 8.0%; p < 0.001) and at 365 days (5.2% vs. 6.7% vs. 18.1%; p < 0.001). This subgroup also had the highest combined rates of death or hospitalization at both 30 days (3.1% vs. 3.5% vs. 9.6%; p < 0.001) and 365 days (12.7% vs. 20.3% vs. 30.5%; p < 0.001). In multivariable models, factors associated with 30-day mortality included a history of stroke (HR > 6), occurrence of CIN (HR > 6), and high FIB-4 index group (HR > 3.5). Additionally, high-sensitive troponin T (hs-TnT) levels were associated with a 3% mortality increase with each 100 ng/l increase. For 1-year mortality, multivariable analysis identified male gender (HR = 1.97), high FIB-4 (≥ 3.25, HR = 2.21), and CIN (HR = 2.76) as independent predictors. The subgroup of patients with a high FIB-4 index is characterized by a higher percentage of CIN, hospitalizations, and deaths from ACS. A high FIB-4 index value is an independent predictor of short- and long-term mortality. The FIB-4 index is an additional risk factor for poor prognosis in patients with ACS.

ResumoFundamento A nefropatia induzida por contraste (NIC) é complicação frequente após procedimentos angiográficos e pode estar relacionada ao volume de contraste administrado. Permanece incerto se o tipo de contraste também influencia sua ocorrência.Objetivo Avaliar a interação entre volume e tipo de contraste (iso-osmolar ou de baixa osmolaridade) no desenvolvimento de NIC.Métodos Subanálise post hoc de pacientes submetidos a procedimentos coronários diagnósticos e terapêuticos, randomizados 1:1 para contraste de baixa osmolaridade ou iso-osmolaridade. A amostra total (n = 2.268) foi estratificada por volume: Grupo I (< 150 ml; n = 1.985) e Grupo II (≥ 150 ml; n = 283), e comparada segundo o tipo de contraste. O desfecho primário foi NIC em 48 e 96 horas após o procedimento. NIC foi definida como elevação da creatinina sérica > 25% ou ≥ 0,5 mg/dl em relação ao nível basal após 48 horas. O efeito do tipo e do volume de contraste foi testado por regressão logística com termo de interação, ajustada para síndrome coronária aguda, disfunção ventricular, creatinina basal, sexo e idade (valor p < 0,05).Resultados Foram incluídos 2.268 pacientes consecutivos; dois terços do sexo masculino; hipertensão arterial sistêmica em 85%, diabetes melito em 52% e doença renal crônica em 31%. No Grupo I, o volume médio de contraste foi 75,3 ± 28,0 ml; no Grupo II, 188,6 ± 46,9 ml. A incidência de NIC foi maior no grupo com maior volume (14,8% vs. 17,7%), sem significância estatística (odds ratioajustado = 1,25; intervalo de confiança de 95% 0,89-1,73; p = 0,191). O modelo com termo de interação não evidenciou correlação entre tipo de contraste e volume (p > 0,999).Conclusão Não houve associação entre o tipo de contraste e a ocorrência de NIC, mesmo entre pacientes expostos a maiores volumes de contraste.

Background:Contrast-induced nephropathy (CIN), a common complication of percutaneous coronary intervention (PCI), adversely affects clinical outcomes by extending hospital stays and increasing healthcare costs. Importantly, CIN is linked to poor prognosis in acute myocardial infarction (AMI) patients. This study evaluated the preventive effect of pre-procedural sodium-glucose cotransporter-2 (SGLT2) inhibitors administration on CIN incidence in AMI patients who received PCI.Methods:A systematic search of PubMed, Web of science, and the Cochrane Library was performed for studies published up to December 12, 2024. Observational studies and clinical trials investigating pre-procedural SGLT2 inhibitors use in PCI-treated AMI patients were included. Following PRISMA guidelines, 2 researchers independently screened the literature, extracted the data, and assessed the bias risk. Data synthesis utilized Review Manager 5.3 with a random-effects model to address heterogeneity. The primary outcomes included CIN incidence (95% confidence intervals (CI)). The secondary outcomes included all-cause mortality, major adverse cardiovascular events (MACE), recurrent myocardial infarction, and heart failure (HF) readmission, which were analyzed via risk ratios(RR) and I² statistics.Results:Five studies involving 3301 patients (SGLT2 inhibitors group: 665; control: 2636) were analyzed. Compared with the control group, the SGLT2 inhibitors group demonstrated significantly lower risks of CIN (RR: 0.55, 95% CI: 0.41–0.73, P < .0001), all-cause mortality (RR: 0.49, 95% CI: 0.29–0.81, P = .005), MACE (RR: 0.33, 95% CI: 0.17–0.65, P = .01), and HF readmission (RR: 0.30, 95% CI: 0.16–0.56, P = .0001). No significant difference was observed in the recurrent myocardial infarction rates (RR: 0.88, 95% CI: 0.38–2.06, P = .77).Conclusion:Pre-procedural SGLT2 inhibitors use significantly reduces CIN incidence, mortality, MACE, and HF readmission in PCI-treated AMI patients, suggesting potential cardiorenal protective benefits.

Contrast-induced nephropathy (CIN) is a common cause of acute renal failure. CIN is defined as an increase in serum creatinine (sCr) occurring after iodinated contrast agent (ICA) administration and is usually transient. When patients with mildly elevated baseline sCr levels are included, the risk of CIN in patients undergoing cardiac catheterization can be as high as 20%. To determine the role of glucose-to-lymphocyte ratio (GLR) in predicting the risk of developing CIN after coronary angiography (CAG). This is a retrospective study that included 929 patients who underwent CAG for non-ST elevation myocardial infarction (NSTEMI). The incidence of CIN was determined. GLR was calculated by dividing the blood glucose level by the lymphocyte count. CIN developed in 124 patients (13.3%) after the CAG procedure including percutaneous coronary intervention. CIN (+) patients were older than CIN (-) group (67.1 ± 10.8 vs. 62.4 ± 11.5, P = 0.046). The number of patients with diabetes mellitus was also higher in CIN (+) group (71 (57.3%) vs. 386 (48%), P < 0.001). Multivariate logistic regression analysis showed that GLR score (OR: 1.025, 95% confidence interval (CI): 1.0221-1.029, P < 0.001), serum glucose levels (OR: 1.011, 95% CI: 1.009-1.013, P < 0.001), white blood cell count (OR: 1.182, 95% CI: 1.101-1.268, P < 0.001), neutrophil-to-lymphocyte ratio score (OR: 1.12 95%CI: 1.077-1.167, P< 0.001) and platelet to lymphocyte ratio score (OR: 1.012, 95% CI: 1.009-1.015, P < 0.001) were independent predictors of the development of CIN. Receiver Operating Characteristic analysis, at a cut-off point of 104.39, GLR demonstrated 70% sensitivity and 82% specificity for detecting CIN. GLR value at admission was associated with the development of CIN after CAG in patients with NSTEMI.

Contrast-induced nephropathy (CIN) is a serious complication following percutaneous coronary intervention (PCI). The Renal dysfunction, Congestive heart failure, Hypertension, Age ≥75 years, Diabetes mellitus and prior Stroke R2CHADS2 score, originally developed for thromboembolic risk assessment, has recently been proposed as a predictor of CIN and major adverse cardiovascular events (MACE). The present study aimed to evaluate the predictive value of the R2CHADS2 score for CIN and long-term MACE in STEMI patients undergoing primary PCI (pPCI). A total of 1204 STEMI patients were included in this retrospective study. Patients were categorized into 3 risk groups based on their R2CHADS2 scores. CIN incidence was significantly higher in the high-risk group (37.1%) compared with the moderate (13.6%) and low-risk groups (5.5%; P < .001). Hemodialysis was required in 14.3% of high-risk patients (P < .001). MACE occurred in 49.3% of the high-risk group, 22.1% of the moderate-risk group, and 12.9% of the low-risk group (P < .001). These findings suggest that the R2CHADS2 score can predict CIN and adverse cardiovascular outcomes in STEMI patients undergoing pPCI.

Abstract Background and Aims Contrast-induced nephropathy (CIN) is one of the common causes of acute kidney injury (AKI), often presenting with a favorable prognosis, which makes it easily overlooked during diagnosis. Due to limited awareness among healthcare professionals, reluctance to perform blood sampling, and concerns about time and cost, renal function evaluation after contrast media exposure is frequently neglected. This study aimed to measure creatinine levels using capillary blood sampling and compare the results with laboratory data to investigate the occurrence of CIN. Method This study was conducted as a single-center, prospective, observational study and targeted patients hospitalized at Geongsang National University Changwon hospital from July 2024 to December 2024. The study included adults aged 18 years or older with chronic kidney disease (CKD) who were exposed to contrast media through procedures such as computed tomography (CT) or coronary angiography (CAG). Exclusion criteria were pediatric patients, patients undergoing hemodialysis, those with AKI within the past three months, and individuals who did not consent to participation. Creatinine levels were measured using capillary blood sampling with the StatSensor device (Nova Biomedical) at three time points: pre-exposure (P0), within 24 hours post-exposure (P1), and within 48 hours post-exposure (P2). These measurements were compared to venous blood samples taken pre-exposure (V0) and within 24–96 hours post-exposure (V2). CIN was defined as an increase in creatinine by ≥0.5 mg/dL or by ≥25% from baseline after contrast media exposure. Results A total of 182 participants were enrolled in the study, with a mean age of 73.25 ± 12.8 years; 56% were male. CIN based on venous blood creatinine criteria was identified in 33 patients (18.1%). Among these, 23 patients (12.6%) had CKD stage 3, and 5 patients (2.7%) each had CKD stages 4 and 5. CIN based on capillary blood creatinine criteria was identified in 37 patients (20.3%), with 29 patients (15.9%) in CKD stage 3 and 4 patients (2.2%) each in CKD stages 4 and 5. CIN occurrence was significantly higher in patients using angiotensin receptor blockers (ARB) (53.7% vs. 72.7%, P = 0.046) and inotropic agents (4.7% vs. 18.2%, P = 0.007) in both capillary and venous blood sampling groups. Notably, CIN occurrence within 24 hours based on capillary sampling was observed in 20 patients (10.9%). Conclusion The incidence of CIN, as determined by capillary and venous blood creatinine measurements, showed no significant difference. The diagnostic concordance rate between the two methods was 89.2%, demonstrating the efficiency of portable creatinine measurement devices. This study suggests the potential use of portable creatinine measurement devices for accurate, convenient, and rapid diagnosis of AKI in the future.

Abstract Background and Aims Contrast-induced nephropathy (CIN) is a complication that causes significant morbidity and mortality in patients with acute coronary syndrome (ACS), even after successful percutaneous coronary intervention (PCI). Early identification of high-risk patients is crucial for prognosis. In this study, we aimed to investigate the predictive value of the Anticoagulation and Risk Factors in Atrial Fibrillation (ATRIA) score, an alternative thromboembolism risk scoring model, in the development of CIN in patients with non-ST-segment elevation myocardial infarction (NSTEMI) undergoing PCI, independent of atrial fibrillation. Method This retrospective study included patients hospitalized in the coronary intensive care unit between 2017 and 2023 with a diagnosis of NSTEMI and treated with PCI. Patients were divided into two groups based on the development of CIN, and their clinical, demographic, and laboratory findings were statistically compared. The ATRIA and CHA2DS2-VASc scores of the patients were calculated. Results A total of 550 patients who underwent PCI due to NSTEMI were included in the study. CIN was observed in 78 patients (14.1%) following PCI. While no difference was found between the groups in terms of gender, the mean age of patients who developed CIN was significantly higher at 67.1 ± 10.8 years compared to those without CIN (P &amp;lt; 0.001). The rates of diabetes, heart failure, and prior stroke were higher in the CIN group. The ejection fraction assessed via transthoracic echocardiography was significantly lower in the CIN group (43.4 ± 12.5%) compared to the non-CIN group (52.2 ± 10.6%) (P &amp;lt; 0.001). The volume of contrast media used during PCI was similar between the groups (P = 0.538). CHA2DS2-VASc and ATRIA scores were significantly higher in patients who developed CIN compared to those who did not (4.31 ± 1.52 vs. 2.23 ± 1.34, P &amp;lt; 0.001; 4.25 ± 2.55 vs. 3.26 ± 2.68, P &amp;lt; 0.001). Conclusion We demonstrated that a high ATRIA score has predictive value for the development of CIN in NSTEMI patients undergoing PCI. Additionally, the CHA2DS2-VASc score, previously shown to be associated with CIN in ACS patients, was also found to provide supplementary information for predicting the incidence of CIN in our study.

Contrast-induced nephropathy (CIN) is an iatrogenic impairment to the kidneys that can occur in susceptible persons after intravascular injections of contrast agents. Individuals undergoing percutaneous coronary intervention (PCI) for acute coronary syndrome (ACS) often bear the risk of developing CIN. The likelihood of CIN can be predicted using several techniques, although none of them are very accurate. CHA2DS2-VASc score is used to predict unfavorable clinical outcomes in patients with ACS and atrial fibrillation. The score comprises preprocedural variables and is simple to calculate and can be used for predicting CIN. This study aims to validate CHA2DS2-VASc score to predict occurrence of CIN among patients undergoing PCI. This cross-sectional research has been carried out at a tertiary care hospital. The study comprised a total of 182 patients who were admitted with ACS and underwent PCI. CIN incidence was computed. The study population was divided into two groups (the CIN group and the non-CIN group) based on the incidence of CIN. The CHA2DS2-VASc score was computed for every patient. The best cutoff values of the CHA2DS2-VASc score to predict the development of CIN were found using receiver operating characteristic (ROC) curve analysis. The incidence of CIN was computed both above and below the CHA2DS2-VASc score's optimal cutoff point. The incidence of CIN among patients undergoing PCI was 14.3%, and the ROC value for the CHA2DS2-VASc score was 0.896. Statistically significant increases in the incidence of CIN were observed in patients undergoing PCI who had a CHA2DS2-VASc score of >2. Additionally, a significant relationship was discovered between CIN and age, diabetes, hypertension, prior coronary artery disease (CAD), and Killip class ≥2. Patients with CHA2DS2-VASc score of >2 had higher incidence of CIN. CHA2DS2-VASc score was found to be useful in predicting contrast nephropathy among patients with acute myocardial infarction undergoing angiography.

Renal impairment following contrast exposure can sometimes become permanent, and data on the long-term impact of coronary computed tomography angiography (CTA) on renal dysfunction are limited. We aimed to examine the incidence and long-term outcome of persistent renal dysfunction after coronary CTA. We identified 3500 patients with creatinine levels measured before and six months after coronary CTA. A total of 2054 patients were included in the final analysis for contrast-induced nephropathy (CIN) diagnosis, defined as a serum creatinine increase of 0.5mg/dl or a relative increase of 25% from baseline. Persistent renal dysfunction was defined as an absolute increase of 0.5 mg/dl or a relative increase of 25% in creatinine levels after at least six months of follow-up. The incidence of CIN was 1.0% and 40 (1.9%) patients had persistent renal dysfunction at median 2.5-year follow-up. Mortality rate was 2.0% (41 patients) and four patients (0.2%) required permanent dialysis during the same period. In multivariate regression analysis; age (odds ratio [OR]: 1.050, p = 0.027), diabetes (OR: 2.769, p = 0.004), baseline renal function (OR: 0.967, p = 0.003), and occurrence of CIN (OR: 7.760, p = 0.002) were identified as independent predictors of persistent renal dysfunction. Furthermore, occurrence of CIN and persistent renal dysfunction were found as independent predictors of long-term mortality. During follow-up after coronary CTA, the incidence of persistent renal dysfunction was 1.9%, and the occurrence of CIN was the most important risk factor. In addition, both CIN and persistent renal dysfunction were associated with long-term mortality.

Background: Contrast-induced nephropathy (CIN) is a major cause of acute kidney injury (AKI) worldwide, with variable prevalence across centres. New biomarkers, such as serum cystatin C, have been introduced for earlier AKI detection, but data from resource-limited settings remain scarce. This study assessed the incidence, predictors, and short-term renal outcomes of CIN using cystatin C and creatinine in patients undergoing contrast-enhanced procedures at the University of Maiduguri Teaching Hospital (UMTH), Nigeria. Methods: In this prospective study, 150 consenting adults (≥18 years) receiving contrast media were enrolled. Sociodemographic data and baseline laboratory measurements, including cystatin C, creatinine, and estimated glomerular filtration rate (eGFR), were obtained. CIN was defined as a ≥0.5 mg/dL or ≥25% rise in serum creatinine within 48–72 hours post-contrast. Logistic regression identified predictors of CIN, and renal outcomes were assessed over three months. Results: CIN prevalence was 30% using creatinine at 48 hours and 49.3% using cystatin C at 24 hours. Independent predictors included older age (OR = 1.346, p = 0.009), higher contrast volume (OR = 2.037, p = 0.001), elevated baseline creatinine (OR = 1.601, p = 0.006), and lower baseline eGFR (OR = 1.767, p = 0.003). Cystatin C sensitivity and specificity ranged from 51.1–68% and 52.4–58.1%, respectively, across 24–72 hours, without superiority over creatinine. Of CIN cases, 73.3% recovered within two weeks; 17.9% had persistent dysfunction, and 4.6% required dialysis. At three months, 62.5% of persistent cases recovered, 25% had ongoing impairment, and 12.5% remained on dialysis. Conclusion: CIN is common in UMTH, with significant short-term renal sequelae. Key risk factors include age, contrast volume, and pre-existing renal impairment. Cystatin C did not outperform creatinine in CIN detection in this cohort.

Background/aimThis study investigates the role of carbon dioxide (CO2) angiography, delivered with an automated CO2 delivery system, in decreasing the amount of iodinated contrast and preventing contrast-induced nephropathy (CIN) in diabetic foot patients who underwent endovascular revascularization.Materials and methodsA total of 272 diabetic foot patients who underwent endovascular treatment for infrainguinal chronic peripheral arterial disease (PAD) were included in the study. Of these, 64 patients underwent endovascular intervention using CO2 angiography (study group), while 208 patients underwent endovascular intervention using only contrast media (control group). The rates of CIN and the amount of contrast used during interventions were recorded alongside secondary outcomes, including technical success, complication rates, and complications related to CO2 usage.ResultsThe mean contrast volume used in the CO2 group was significantly lower than in the control group (24.3 ± 13.3 cc vs 89.4 ± 24.8 cc; p < 0.001). CIN was detected in 41 patients. The incidence of CIN was 17.7% in the control group, while it was significantly lower in the CO2 group at 6.2% (p = 0.024). In a subgroup of patients with chronic kidney disease stage 3–5, CIN incidence remained significantly lower in the CO2 group (6.2% vs 38.2%, p < 0.001), and multivariate analysis identified CO2 use as an independent protective factor (OR: 0.027, 95% CI: 0.005–0.133, p < 0.001). Technical success rates were comparable between the groups (93.7% vs 93.2%; p = 0.892). Pain after CO2 injection was recorded in 11 patients, and no other adverse effect due to CO2 usage was observed. There were no major complications, and only minor complications occurred (8%).ConclusionCO2 angiography may play a crucial role in minimizing the risk of CIN in this specific population, who are more vulnerable to this complication and its associated morbidity and mortality. Further multicenter prospective studies are needed to better define the role of CO2 angiography in high-risk patients.

Contrast-induced nephropathy (CIN) is a significant complication following the administration of radiocontrast media, defined as acute deterioration of renal function within 24 to 48 hours post-procedure. It represents the third most common cause of hospital-acquired acute kidney injury, accounting for approximately 11% of cases. CIN increases short-term morbidity and mortality while accelerating the progression of chronic kidney disease (CKD). This study investigated the prevalence, risk factors, and short-term outcomes of CIN among CKD patients undergoing contrast studies at 2 tertiary care centers in Sri Lanka. This descriptive cross-sectional study was conducted at the nephrology units of Colombo North Teaching Hospital and Teaching Hospital Kurunegala from August 2018 to September 2023. The study included 405 CKD patients over 18 years referred for pre-procedural nephrology consultation before undergoing contrast-enhanced imaging. All patients received intravenous normal saline hydration (1 mL/kg/h) 12 hours before and after contrast administration, with temporary discontinuation of nephrotoxic medications. Data was collected via an interviewer-administered questionnaire. CIN was defined per KDIGO guidelines as a rise in serum creatinine >25% or 0.5 mg/dL from baseline. The mean age of patients was 62.6 years (SD = 12.4), with 310 (76.5%) being male. Comorbidities included diabetes mellitus (48.9%), hypertension (44.2%), coronary artery disease (13.3%), and chronic liver disease (6.2%). CIN occurred in 45 patients (11.1%), with diabetes mellitus identified as a significant risk factor (P = .0044). Arterial contrast administration had a higher risk (17.7%) than venous administration (10.7%). Seven patients (1.7%) required acute hemodialysis, and 1 patient died. Age, gender, and CKD stage did not significantly influence CIN development. CIN remains a common complication in CKD patients undergoing contrast studies, with diabetes mellitus being a significant independent risk factor. Pre-procedural risk assessment and appropriate prophylactic measures are essential to minimize CIN incidence and associated complications.