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Published on: April 18, 2013
Impact of anemia on contrast-induced nephropathy (CIN) in patients undergoing percutaneous coronary interventions
Wen-hua Li1, Dong-ye Li, Fei Han
1Department of Cardiology, Affiliated Hospital of Xuzhou Medical College, No. 99 Huihai west Road, Xuzhou, 221002, China. wenhualicn@yeah.net
Insights
Anemia increases the risk of contrast-induced nephropathy (CIN) after angioplasty, especially in patients with moderate kidney dysfunction. Hemoglobin levels and kidney function are key predictors of CIN development.
Area of Science:
- Nephrology
- Cardiology
- Internal Medicine
Background:
- Contrast-induced nephropathy (CIN) is a significant complication following percutaneous coronary angioplasty (PCA).
- The role of anemia as a risk factor for CIN requires further elucidation.
Purpose of the Study:
- To evaluate the impact of anemia on the incidence of CIN after PCA.
- To identify predictors of CIN in patients undergoing PCA.
Main Methods:
- Serum creatinine was measured pre- and post-procedure to define CIN (≥0.5 mg/dl or ≥25% increase).
- Anemia was defined by hemoglobin levels (<120 g/l women, <130 g/l men).
- Multivariate logistic regression analyzed predictors of CIN.
Main Results:
- CIN developed in 3.1% of 1,026 patients; 6.3% of anemic vs. 2.2% of non-anemic patients (P<0.01).
- CIN incidence increased with lower baseline eGFR in both groups.
- Anemic patients with moderate renal dysfunction (eGFR 30-59 ml/min) had twofold higher CIN risk (7.9% vs. 3.8%, P<0.05).
Conclusions:
- Anemia is linked to a higher CIN incidence in patients with moderate renal dysfunction.
- Preexisting renal insufficiency and anemia are independent predictors of CIN.
- Baseline hemoglobin and eGFR are crucial for predicting CIN risk.
Background:
The aim of the present study was to assess the influence of anemia on the risk of developing contrast-induced nephropathy after percutaneous coronary angioplasty.
Methods:
Serum creatinine values were measured before and within 48 h after the administration of contrast agents. Contrast-induced nephropathy (CIN) was defined as an increase of ≥ 0.5 mg/dl or ≥ 25 % in serum creatinine concentration over baseline within 48 h after administration. Anemia was defined as hemoglobin <120 g/l in women and <130 g/l in men.
Results:
Among the 1,026 patients studied, 32 (3.1 %) developed CIN after procedure. CIN occurred in 6.3 % of the anemic patients and in 2.2 % of the non-anemic patients (P < 0.01). The incidence of CIN increased with decreasing of baseline estimated glomerular filtration rate (eGFR) in both the anemia and non-anemia groups. In patients with baseline eGFR <30 ml/min, a high proportion of both anemic and non-anemic patients experienced CIN (24.6 vs. 17.5 %). When baseline eGFR was 30-59 ml/min, the incidence of CIN in anemic patients was twofold higher than in non-anemic patients (7.9 vs. 3.8 %; P < 0.05). Multivariate logistic regression analysis found that baseline eGFR and baseline hemoglobin were independent predictors of CIN.
Conclusion:
Anemia is associated with a higher incidence of CIN in patients with moderate renal dysfunction. Patients with both preexisting renal insufficiency and anemia are at high risk of CIN. Baseline eGFR and baseline hemoglobin are independent predictors of CIN.
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