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Nephropathy induced by contrast medium in an hispanic population after coronary angiography
José González Moreno1, Leon Ferder, José Gómez
1Department of Internal Medicine of the Ponce School of Medicine and Damas Hospital, Ponce, Puerto Rico. J3g76@yahoo.com
Insights
Contrast medium-induced nephropathy (CIN) is a significant complication. Adherence to preventive hydration guidelines was low in high-risk patients, indicating a need for improved institutional protocols to reduce CIN incidence.
Area of Science:
- Nephrology
- Radiology
- Hospital-acquired complications
Background:
- Contrast medium-induced nephropathy (CIN) is a major complication of intravascular contrast media, ranking as the third leading cause of hospital-acquired acute kidney injury.
- CIN incidence can reach 10% in patients with normal renal function, escalating to 25% in those with risk factors.
Purpose of the Study:
- To evaluate the incidence of CIN in a hospital setting.
- To assess adherence to preventive strategies for CIN.
- To identify potential factors contributing to CIN development.
Main Methods:
- Retrospective analysis of 192 medical records.
- Inclusion/exclusion criteria applied to identify 55 eligible patients.
- Review of CIN development, risk factors, and adherence to preventive hydration protocols.
Main Results:
- CIN was identified in 7% of patients (4 cases), all of whom were high-risk.
- Only 50% of patients who developed CIN received guideline-recommended preventive IV hydration.
- In high-risk patients without CIN, 77% received preventive hydration, suggesting potential efficacy of the intervention.
Conclusions:
- The study did not establish diabetes as a direct cause of CIN, partly due to unstratified glycemia data.
- Significant gaps were observed in the diligent compliance with screening and preventive strategies for CIN within the institution.
- There is a critical need to implement a standardized institutional protocol for CIN prevention aligned with established guidelines.
Unlabelled:
Contrast medium-induced nephropathy (CIN) is regarded as one of the most important complications after intravascular administration of radiographic contrast media and the third most common cause of hospital-acquired acute kidney injury. Contrast-induced nephropathy may develop in up to10% of patient with normal renal function but may be as high 25% in patient with risk factors.
Methods:
A total of 192 medical records were obtained, in which 55 patient were eligible by our inclusion and exclusion criteria.
Results:
A total four cases of CIN (7%) was identified and all were considered high-risk patients. In the patients that developed CIN only 50% received preventive IV hydration therapy in accordance to guidelines of the Contrast-Induced Nephropathy Consensus Panel. In 51 cases CIN was absent (93%). In the absent CIN group 22 were considered high-risk patients (43%) and 29 patients were low risk (57%). In the high-risk group with absent CIN, 77% received preventive IV hydration.
Conclusion:
Study didn't show diabetes as a direct contributory factor for CIN development, but glycemia was not properly stratified. Screening and preventive strategies were not diligently complied in our institution, so there is a great need to incorporate a protocol in our institution in accordance to published guidelines.
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