Does metabolic syndrome increase contrast-induced nephropathy in patients with normal renal function?

Area of Science:

• Cardiology
• Nephrology
• Metabolic Disorders

Background:

• Contrast-induced nephropathy (CIN) is a significant complication following coronary angiography (CAG) and percutaneous coronary intervention, associated with increased mortality and morbidity.
• Patients with metabolic syndrome (Mets) represent a growing population undergoing these procedures, yet their specific risk for CIN requires further elucidation.

Purpose of the Study:

• To compare the incidence of CIN in patients with and without metabolic syndrome undergoing CAG.
• To assess the association between metabolic syndrome and the risk of developing contrast-induced nephropathy.

Main Methods:

• A case-control study involving 260 patients undergoing CAG, divided into 130 with Mets and 130 without Mets, all with normal baseline renal function.
• Serum creatinine (Cr) levels were measured before and 48 and 72 hours after angiography.
• Statistical analysis included two-way ANOVA with repeated measures and logistic regression models.

Main Results:

• Metabolic syndrome was associated with higher triglyceride, fasting blood glucose, and diastolic blood pressure, and lower HDL-C.
• Both groups showed increased blood urea nitrogen (BUN) and Cr levels post-angiography.
• The incidence of increased Cr levels at 48 and 72 hours post-injection was significantly higher in the Mets group (P=0.016 and P=0.021, respectively).
• Developing metabolic syndrome was significantly associated with an increased risk of acute kidney injury (AKI), elevating nephropathy risk (OR=7.14, P=0.001).

Conclusions:

• Metabolic syndrome is a significant independent risk factor for contrast-induced nephropathy.
• The incidence of CIN is substantially higher in patients with metabolic syndrome compared to those without.
• Identifying and managing metabolic syndrome is crucial for mitigating CIN risk in patients undergoing CAG.