Obesity as a Risk Factor for Radiographic Contrast-Induced Nephropathy

Area of Science:

• Nephrology
• Cardiology
• Radiology

Background:

• Contrast-induced nephropathy (CIN) is a significant complication following radiocontrast procedures.
• Preexisting renal impairment, diabetes, and advanced age are known risk factors for CIN.
• Identifying modifiable risk factors is crucial for preventing CIN, especially in patients with peripheral arterial disease.

Purpose of the Study:

• To investigate the specific risk factors associated with CIN in patients with peripheral arterial disease undergoing angiography.
• To evaluate the role of obesity, kidney function, diabetes, age, and contrast volume in CIN development.
• To identify novel risk factors for CIN to improve patient management.

Main Methods:

• A single-center prospective study involving 94 patients with peripheral arterial disease scheduled for angiography.
• Serum creatinine levels were monitored at baseline and at 1, 2, and 7 days post-angiography.
• Chronic kidney disease staging and body mass index (BMI) were assessed, with all patients receiving standardized hydration and low-osmolality contrast media.

Main Results:

• Six out of 94 patients (6.4%) developed CIN, with one requiring dialysis and another experiencing renal failure-related death.
• Body Mass Index (BMI) (P = .019) and baseline kidney function (P = .001) were significantly associated with CIN.
• Obesity (BMI ≥30) was strongly linked to CIN (P = .0092), with 4 out of 6 CIN patients being obese. Diabetes, contrast volume, and age were not significant risk factors.

Conclusions:

• Preexisting renal impairment is confirmed as a significant risk factor for CIN.
• Obesity emerges as a potential novel risk factor for CIN, warranting further investigation.
• These findings may aid in identifying high-risk patients for CIN, potentially reducing its incidence and impact.