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Colegio de Medicina Interna de México.

2010, Number 3

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Med Int Mex 2010; 26 (3)

Nephropathy due to contrast medium in cardiac angiography

Valdez DR, Wong ER, Flores YE, Basoni RAE, Esquivel MCG, González OLA, Chávez LL, López RJL

Language: Spanish
References: 23
Page: 226-236
PDF size: 161.28 Kb.


ABSTRACT

Background: The nephropathies by means of contrast it is one of the factors more important etiologists of sharp renal inadequacy in hospitalized patients, being constituted in a significant cause of morbimortalidad.
Objective: To determine the incidence of contrast induced nephropathy in subjects undergoing cardiac angiography, as well as the variation of renal function and serum creatinine at 24, 48 and 72 hours after the procedure.
Material and Method: We studied 217 consecutive subjects undergoing cardiac angiography, with determination of serum creatinine before the procedure. It was determined the serum creatinine at 24, 48 and 72 hours after the procedure and creatinine clearance by formula of Cockcroft-Gault. Contrast induced nephropathy was defined as an absolute increase in the serum creatinine level ≥ 0.5 mg/dl or ≥ 25% within 48 hours after the procedure.
Results: We determined the serum creatinine at 24 hours: 217 subjects, at 48 hours: 111 subjects, and at 72 hours: 76 subjects. Sixteen (7.3%) of the 217 subjects, developed contrast induced nephropathy. The following factors were predictors of contrast induced nephropathy: glucose › 122 mg/dL (odds ratio [OR] = 7.30), serum creatinine level &38250 1.5 mg/dL (OR = 122.06), Men (OR = 7.71), left ventricular ejection fraction ‹ 50% (OR = 4.6). There was a decrease of creatinine clearance within 24 hours of 7.74 mL/min (11.9%), at 48 hours of 17.32 mL/ min (26.87%), at 72 hours of 19.48 mL/min (30.22%) with respect to the basal level of creatinine clearance.
Conclusions: The incidence of contrast induced nephropathy is similar to that reported in literature. The pre-existing renal insufficiency, hyperglycemia, gender (male) and left ventricular ejection fraction ‹ 50% are predictors of contrast induced nephropathy. There is greater variation of renal function at 48 hours after the procedure.


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