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Relationship between red cell distribution width and contrast-induced nephropathy in patients who underwent primary
Dursun Çayan Akkoyun1, Aydın Akyüz1, Ömer Kurt2
1Department of Cardiology, Namik Kemal University Faculty of Medicine, Tekirdag, Turkey.
Insights
Red cell distribution width (RDW) is a predictor of contrast-induced nephropathy (CIN) in ST-elevation myocardial infarction (STEMI) patients undergoing percutaneous coronary intervention (PCI). Higher RDW levels indicate increased risk for CIN, alongside diabetes and reduced kidney function.
Area of Science:
- Cardiology
- Nephrology
- Biomarkers
Background:
- Contrast-induced nephropathy (CIN) is a complication following percutaneous coronary intervention (PCI).
- Identifying predictors of CIN is crucial for patient management and risk stratification.
- Red cell distribution width (RDW) is an emerging biomarker associated with various cardiovascular conditions.
Purpose of the Study:
- To investigate the association between red cell distribution width (RDW) and the incidence of contrast-induced nephropathy (CIN).
- To evaluate RDW as a potential predictor of CIN in patients with ST-elevation myocardial infarction (STEMI) undergoing primary PCI.
Main Methods:
- A cohort of 359 STEMI patients undergoing primary PCI was analyzed.
- CIN was defined as a 25% increase in serum creatinine or >0.5 mg/dL increase from baseline within 48 hours.
- Red cell distribution width (RDW) levels were measured and compared between CIN-positive and CIN-negative groups.
Main Results:
- 13.8% of patients developed CIN.
- CIN-positive patients exhibited significantly higher RDW values compared to CIN-negative patients (16.9% vs 14.8%, p<0.001).
- Independent predictors of CIN included diabetes mellitus, high RDW, low baseline glomerular filtration rate (GFR), elevated ∆-creatinine, and increased contrast media volume.
Conclusions:
- Elevated red cell distribution width (RDW) is an independent predictor of contrast-induced nephropathy (CIN) in STEMI patients undergoing PCI.
- Other significant predictors include diabetes mellitus, low baseline GFR, and the amount of contrast media used.
- RDW may serve as a valuable biomarker for assessing CIN risk in this patient population.
Objective:
This study evaluated the relationship between contrast-induced nephropathy (CIN) and red cell distribution width (RDW) in patients who underwent primary percutaneous coronary intervention (PCI).
Methods:
A total of 359 patients with ST elevation myocardial infarction (STEMI) who had undergone primary PCI were included in the study. An increase of 25% in serum creatinine value after 48 h, or an increase of >0.5 mg/dL in the basal value was defined as CIN.
Results:
Of the patients included in the study, 49 (13.8%) developed CIN. Compared to the CIN-negative group, CIN-positive patients had increased RDW values (16.9 ± 2.00 and 14.8 ± 2.14 respectively, p<0.001). The latter were also older patients, and had increased age rates of diabetes mellitus, baseline creatinine, ∆-creatinine and amount of contrast media were higher and left ventricular ejection fraction and baseline glomerular filtration rate (GFR) were lower in the CIN-positive group than in the CIN-negative group. A statistically weak correlation was found between RDW and change in creatinine levels (∆-creatinine) (r=0.250, p=0.002). Diabetes mellitus (odds ratio [OR]: 3.252, 95% CI=1.184-8.951, p=0.022), high RDW (OR: 1.716, 95% CI=1.363-2.157, p<0.001), baseline low GFR (OR: 0.941, 95% CI=0.925-0.971, p<0.001), ∆-creatinine (OR: 1.197, 95% CI=1.061-2.986, p=0.006) and increased amount of contrast media (OR: 1.187, 95% CI=1.048-3.02, p=0.001) used were observed as independent predictors of CIN.
Conclusion:
The study found diabetes mellitus, high RDW, basal low GFR, ∆-creatinine and increased contrast amount used to be the independent predictors of CIN in STEMI patients who underwent PCI.
