Risk for Contrast Nephropathy in Patients Undergoing Coronarography

• Published in: Artificial organs Vol. 34; no. 6; pp. E193 - E199
• Main Authors: Manna, Gaetano La, Pancaldi, Leonardo Goffredo, Capecchi, Alessandro, Maska, Edlira, Comai, Giorgia, Cappuccilli, Maria L., Carretta, Elisa, Lombardi, Alessandro, Colì, Luigi, Stefoni, Sergio
• Format: Journal Article
• Language: English
• Published: Malden, USA Blackwell Publishing Inc 01.06.2010
• Subjects: Acute renal failure; Aged; Aged, 80 and over; Cardiology; Continuous venovenous hemofiltration; Contrast media; Contrast Media - adverse effects; Contrast media-induced nephropathy; Coronarography; Coronary Angiography - adverse effects; Female; Humans; Kidney Diseases - chemically induced; Kidney Diseases - epidemiology; Male; Periprocedural hydration; Risk Factors
• ISSN: 0160-564X; 1525-1594
• DOI: 10.1111/j.1525-1594.2009.00984.x

Among the causes of in‐hospital acute renal failure, contrast‐induced nephropathy ranks third in prevalence. Although it represents a condition of renal impairment with spontaneous recovery, contrast nephropathy should always be considered, because it prolongs hospitalization and it may become a severe complication requiring dialysis. The purposes of this study are: (i) to determine if the application of the most effective contrast‐induced nephropathy prevention strategies in the Cardiology Intensive Care Unit can prove to be successful in reducing nephropathy risk; and (ii) to identify which of the involved risk factors persist after the preventive treatment. We examined the patients who had a coronarography at the Bentivoglio hospital from April 2007 to April 2008 who required at least 3 days of permanence in hospital due to the presence of potential risk factors; 136 out of 784 patients were included. Among the selected patients, 21 (15.44%) developed a renal impairment compatible with contrast‐induced nephropathy. The risk factors that seemed to display the best correlation with risk of contrast nephropathy were advanced age and an ventricular failure (ejection fraction <40%); however, the critical condition did not appear to be due to a single risk factor, but it resulted from the association of more contextual risk factors. Particularly, the concomitant presence of ventricular failure, anemia, diabetes, previous myocardial infarction and advanced age (>70 years) determined a threefold increased risk of contrast nephropathy. Our data suggest that the development of contrast nephropathy following coronarography is associated with worse renal function during hospitalization and at discharge.