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Predictors for contrast media-induced nephropathy and long-term survival: prospectively assessed data from the

Birgit Hölscher1, Christine Heitmeyer, Manfred Fobker

  • 1Medizinische Klinik und Poliklinik C, University Hospital of Münster, Germany.

The Canadian Journal of Cardiology
|November 7, 2008
PubMed

Insights

This prospective study found that postprocedural hemodialysis, ACE inhibitors, reduced kidney function, and contrast volume predict contrast-induced nephropathy (CIN). Long-term survival is better predicted by renal function at 30 days than by early CIN.

Area of Science:

  • Nephrology
  • Cardiology
  • Radiology

Background:

  • Contrast media-induced nephropathy (CIN) is a significant concern.
  • Previous studies lacked prospective data on long-term outcomes of CIN.

Purpose of the Study:

  • To prospectively identify predictors of CIN.
  • To evaluate the long-term outcomes for patients who develop CIN.

Main Methods:

  • 412 patients with moderate renal impairment undergoing coronary angiography were enrolled.
  • Patients received hydration alone, hydration plus hemodialysis, or hydration plus N-acetylcysteine.

Main Results:

  • Predictors of CIN within 72 hours included postprocedural hemodialysis, ACE inhibitor use, lower baseline GFR, and contrast volume.
  • Elevated creatinine at 30 days, not CIN within 72 hours, predicted increased long-term mortality.
  • Reduced left ventricular ejection fraction, higher serum phosphate, and lower hemoglobin also predicted mortality.

Conclusions:

  • Postprocedural hemodialysis, ACE inhibitors, reduced GFR, and contrast volume are key predictors of early CIN.
  • Renal function assessment at 30 days is more crucial for predicting long-term survival than early CIN detection.
Abstract

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