Outcomes of contrast-induced nephropathy: experience in patients undergoing cardiovascular intervention

Area of Science:

• Nephrology
• Cardiology
• Radiology

Background:

• Iodinated contrast media use is rising with advancements in computed tomography and percutaneous coronary intervention (PCI).
• Contrast-induced nephropathy (CIN) is a significant complication, impacting long-term patient morbidity and mortality.
• CIN has been extensively studied in cardiology patients, revealing various adverse outcomes.

Purpose of the Study:

• To review the incidence and outcomes of CIN in cardiology patients, particularly those undergoing PCI.
• To highlight CIN-associated complications and their impact on patient mortality.
• To emphasize the importance of precautionary measures in patients at risk for CIN.

Main Methods:

• Literature review of studies on contrast media use, CIN, and patient outcomes in cardiology.
• Analysis of reported complications associated with CIN in PCI patients.
• Examination of mortality rates in patients with CIN, including those requiring dialysis.

Main Results:

• CIN is linked to increased rates of bleeding, hematoma, stroke, ARDS, electrolyte imbalances, and sepsis in PCI patients.
• Patients with CIN undergoing PCI experience higher rates of myocardial infarction and vessel reocclusion.
• In-hospital mortality is elevated in patients with CIN, with 1-year mortality exceeding 55% for those requiring dialysis post-PCI.

Conclusions:

• CIN significantly increases mortality risk, even with moderate renal dysfunction not requiring dialysis, in patients with coronary artery disease.
• Precautionary measures, including hydration and judicious contrast media use, are vital for patients with renal insufficiency or other CIN risk factors.
• Implementing preventive strategies before, during, and after contrast media administration can reduce CIN incidence and improve patient prognosis.