Is eGFR ≥60 mL/min/1.73 m² in Patients Undergoing Coronary Angiography Really Safe for Contrast Nephropathy?

Area of Science:

• Nephrology
• Cardiology
• Radiology

Background:

• Contrast-induced acute kidney injury (CI-AKI) is a significant complication following contrast media exposure during procedures like coronary artery angiography (CAG).
• Identifying predictive factors for CI-AKI is crucial for patient risk stratification and preventive strategies.

Purpose of the Study:

• To identify independent risk factors for contrast-induced acute kidney injury (CI-AKI) in patients undergoing coronary artery angiography (CAG).
• To evaluate the predictive value of estimated glomerular filtration rate (eGFR) for CI-AKI, particularly in patients with preserved kidney function.

Main Methods:

• Retrospective cohort study including 2923 patients who underwent CAG between March 2014 and January 2022.
• Univariate and multivariate logistic regression analyses were performed to identify predictive factors for CI-AKI.
• Subgroup analysis and ROC curve analysis were conducted to assess the role of eGFR.

Main Results:

• CI-AKI occurred in 2.6% of patients (77 out of 2923).
• Multivariate analysis identified diabetes mellitus (DM), chronic kidney disease (CKD), and lower estimated glomerular filtration rate (eGFR) as independent predictors of CI-AKI.
• In patients with eGFR ≥60 mL/min/1.73 m², eGFR remained a significant predictor (OR: 0.89, 95% CI: 0.84-0.93).
• An eGFR cut-off of 70 mL/min/1.73 m² was identified for predicting CI-AKI in this subgroup.

Conclusions:

• Diabetes mellitus, chronic kidney disease, and lower eGFR are significant risk factors for CI-AKI post-CAG.
• eGFR is a critical predictor of CI-AKI even in patients with baseline eGFR ≥60 mL/min/1.73 m², highlighting the importance of assessing kidney function meticulously.