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High-throughput Fluorometric Measurement of Potential Soil Extracellular Enzyme Activities
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[Not Available].

Justor Banda1, Raquel Duarte, Caroline Dickens

  • 1Department of Internal Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; Division of Nephrology, Charlotte Maxeke Johannesburg Academic Hospital, Johannesburg, South Africa. katusib@yahoo.co.uk.

South African Medical Journal = Suid-Afrikaanse Tydskrif Vir Geneeskunde
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Summary
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Contrast-induced nephropathy (CIN) affects 4.6-16.4% of patients in sub-Saharan Africa, increasing mortality risk. Patients with anemia and hypoalbuminemia require caution when undergoing contrast media administration.

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Area of Science:

  • Nephrology
  • Radiology
  • Public Health

Background:

  • Contrast-induced nephropathy (CIN) is a significant cause of hospital-acquired acute kidney injury (AKI), contributing to morbidity, mortality, and increased healthcare costs.
  • Data on CIN rates, risk factors, and outcomes in sub-Saharan Africa are lacking.

Purpose of the Study:

  • To investigate the incidence and risk factors of CIN in hospitalized patients in sub-Saharan Africa.
  • To determine the impact of CIN on patient outcomes, including hospitalization length and in-hospital mortality.

Main Methods:

  • A prospective observational study was conducted at Charlotte Maxeke Johannesburg Academic Hospital, South Africa.
  • 371 hospitalized patients undergoing contrast media administration for CT scans or angiography were recruited and followed for AKI development.
  • CIN was defined as a serum creatinine increase >25% or >44 μmol/L within 48-72 hours post-contrast exposure.

Main Results:

  • The incidence of CIN was 4.6% (absolute increase) and 16.4% (relative increase).
  • Anemia (RR 1.71) and hypoalbuminemia (trend RR 1.68) were significant predictors of CIN.
  • Mortality was significantly higher in the CIN group (22.4% vs. 6.8%), and CIN combined with anemia further increased mortality risk (RR 2.39-3.32).

Conclusions:

  • CIN occurs with relatively high incidence in sub-Saharan Africa and is associated with poorer clinical outcomes.
  • The presence of CIN and anemia are positive predictors of mortality.
  • Clinical caution is advised for patients with hypoalbuminemia and anemia undergoing contrast media administration.