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Impact of low hemoglobin on the development of contrast-induced nephropathy: A retrospective cohort study

Jinzhong Xu1, Meiling Zhang2, Yinghua Ni3

  • 1Department of Clinical Pharmacy, The Affiliated Wenling Hospital of Wenzhou Medical University, Wenling, Zhejiang 317500, P.R. China; College of Pharmaceutical Sciences, Wenzhou Medical University, Wenzhou, Zhejiang 325035, P.R. China.

Experimental and Therapeutic Medicine
|July 23, 2016
PubMed

Insights

Low hemoglobin levels significantly increase the risk of contrast-induced nephropathy (CIN) following coronary angiography/percutaneous coronary intervention. Monitoring hemoglobin is crucial before and during contrast media administration to prevent CIN.

Area of Science:

  • Nephrology
  • Cardiology
  • Radiology

Background:

  • Iodinated contrast media used in coronary angiography (CAG) and percutaneous coronary intervention (PCI) can cause contrast-induced nephropathy (CIN).
  • The role of hemoglobin levels as a risk factor for CIN in patients with normal renal function undergoing CAG/PCI is not well-established.

Purpose of the Study:

  • To assess the impact of low hemoglobin levels on the development of CIN in patients undergoing CAG/PCI.
  • To identify independent risk factors for CIN in patients with varying hemoglobin levels.

Main Methods:

  • A cohort of 841 patients undergoing CAG/PCI were divided into low (<120 g/l males, <110 g/l females) and normal hemoglobin groups.
  • Multiple logistic regression analysis was used to determine risk factors for CIN.
  • Serum creatinine changes were compared between groups.

Main Results:

  • CIN developed in 14.7% of patients with low hemoglobin versus 5% in normal hemoglobin groups (P<0.01).
  • Independent risk factors for CIN in low hemoglobin patients included contrast volume ≥200 ml, diuretic use, low hemoglobin, and diabetes.
  • Optimal hemoglobin cut-off points for high CIN risk were 111.5 g/l (females) and 115.5 g/l (males).

Conclusions:

  • Low hemoglobin levels are an independent risk factor for developing contrast-induced nephropathy after CAG/PCI.
  • Patients with reduced hemoglobin require close monitoring during iodinated contrast media administration.
  • Specific risk factors for CIN differ between patients with low and normal hemoglobin levels.

Keywords:
contrast mediacontrast-induced nephropathylow hemoglobin

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