Abstract 13680: Impact of Estimated Glomerular Filtration Rate and Proteinuria on Contrast-induced Nephropathy in Patients With Cardiac Catheterization

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Yoshihiko Saito ◽  
Makoto Watanabe ◽  
Kazutaka Aonuma ◽  
Atsushi Hirayama ◽  
Nagara Tamaki ◽  
...  
Keyword(s):  
Glomerular Filtration Rate ◽  
Glomerular Filtration ◽  
Cardiac Catheterization ◽  
Filtration Rate ◽  
Estimated Glomerular Filtration Rate ◽  
Multivariate Logistic Regression Analysis ◽  
Hazard Ratio ◽  
Contrast Induced Nephropathy ◽  
Multicenter Cohort Study ◽  
Ca Antagonist

Background: Contrast induced nephropathy (CIN) has been a subject of concern to cardiologists in recent year because CIN is associated with increased morbidity, mortality, and healthcare expense. Incidence and risks of contrast induced nephropathy (CIN) after cardiac catheterization are not clear in Japan. Objective: The aim of this study is to investigate the pre-procedural predictors of CIN. Methods: This study, named the study for CIN after cardiac catheterization in Japan (the CINC-J study), is a multicenter cohort study, which examined 1021 patients undergoing cardiac catheterization from 29 hospitals in all over Japan. We divided into 4 groups on the basis of estimated glomerular filtration rate (eGFR: >60 ml•min-1•1.73m-2 = Normal, 45 to 60 = Mild, 30 to 45 = Moderate, <30 = Severe). CIN was defined as an increase in serum creatinine level of 0.5mg/dl or 25% from 48 to 72 hours after contrast-medium injection. Results: The incidence of CIN was significantly higher in patients with proteinuria than those without proteinuria (13.6% vs. 2.8%, p<0.001). In patients without proteinuria, the incidence of CIN was not increased with reducing eGFR, however, in patients with proteinuria, the incidence of CIN was significantly increased with reducing eGFR as shown in the figure. Multivariate-logistic-regression analysis revealed that proteinuria (hazard ratio=3.77; 95% CI: 1.54 to 9.10), contrast volume/eGFR (hazard ratio=1.29; 95% CI: 1.01 to 1.62), Ca antagonist (hazard ratio=3.46; 95% CI: 1.36 to 9.94) were independent predictors of CIN. Conclusions: Proteinuria is the strongest predictor for CIN after cardiac catheterization.

scholarly journals Estimated glomerular filtration rate and postoperative mortality in patients undergoing non-cardiac and non-neuron surgery: a single-center retrospective study

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Xueying Luo ◽  
Sujing Zheng ◽  
Baoer Liu ◽  
Liping Yang ◽  
Ya Li ◽  
...  
Keyword(s):  
Glomerular Filtration Rate ◽  
Glomerular Filtration ◽  
Odds Ratio ◽  
Filtration Rate ◽  
Inflection Point ◽  
Estimated Glomerular Filtration Rate ◽  
Multivariate Logistic Regression Analysis ◽  
Postoperative Mortality ◽  
Ratio Test ◽  
Clinical Records

Abstract Background There is limited evidence to clarify the specific relationship between preoperative estimated glomerular filtration rate (preop-eGFR) and postoperative 30-day mortality in Asian patients undergoing non-cardiac and non-neuron surgery. We aimed to investigate details of this relationship. Methods We reanalyzed a retrospective analysis of the clinical records of 90,785 surgical patients at the Singapore General Hospital from January 1, 2012 to October 31, 2016. The main outcome was postoperative 30-day mortality. Results The average age of these recruited patients was 53.96 ± 16.88 years, of which approximately 51.64% were female. The mean of preop-eGFR distribution was 84.45 ± 38.56 mL/min/1.73 m2. Multivariate logistic regression analysis indicated that preop-eGFR was independently associated with 30-day mortality (adjusted odds ratio: 0.992; 95% confidence interval [CI] 0.990–0.995; P < 0.001). A U-shaped relationship was detected between preop-eGFR and 30-day mortality with an inflection point of 98.688 (P for log likelihood ratio test < 0.001). The effect sizes and confidence intervals on the right and left sides of the inflection point were 1.013 (1.007 to 1.019) [P < 0.0001] and 0.984 (0.981 to 0.987) [P < 0.0001], respectively. Preoperative comorbidities such as congestive heart failure (CHF), type 1 diabetes, ischemic heart disease (IHD), and anemia were associated with the odds ratio of preop-eGFR to 30-day mortality (interaction P < 0.05). Discussion The relationship between preop-eGFR and 30-day mortality is U-shaped. The recommended preop-eGFR at which the rate of the 30-day mortality was lowest was 98.688 mL/min/1.73 m2.

scholarly journals MO415DOES LOW CONTRAST VOLUMES REDUCE RATES OF CONTRAST-INDUCED NEPHROPATHY IN PATIENTS UNDERGOING CORONARY ANGIOGRAPHY?

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Emna Chaabouni ◽  
Hela Jbali ◽  
Najjar Mariem ◽  
Mzoughi Khadija ◽  
Zouaghi Mohamed karim
Keyword(s):  
Renal Function ◽  
Risk Factor ◽  
Glomerular Filtration Rate ◽  
Coronary Angiography ◽  
Contrast Media ◽  
Glomerular Filtration ◽  
Filtration Rate ◽  
Estimated Glomerular Filtration Rate ◽  
Contrast Induced Nephropathy ◽  
Contrast Dose

Abstract Background and Aims Coronary angiography (CAG) necessitates administration of iodinated contrast, which may precipitate an acute deterioration in renal function (contrast-induced nephropathy). Previous work on contrast-induced nephropathy (CIN) has identified contrast volume as a risk factor and suggested that there is a toxic contrast dose above which the risk of CIN is markedly increased. The focus of this study is to provide a critical appraisal of this modifiable risk factor. Method We prospectively enrolled 158 patients who CAG with or without percutaneous coronary intervention from December 2017 to February 2018 at a cardiology department . CIN was defined as an increase in serum creatinine level &gt;25% or 0.5 mg/dL after 48 hours postcardiac catheterization. Toxic contrast dose was defined as a ratio volume of contrast media to estimated glomerular filtration rate (V/eGFR) &gt; 2 . Multivariable regression was conducted to evaluate the effect of exceeding the toxic contrast dose on CIN. Results Of 158 patients (females = 36.1%, mean age 60.0 ± 11 years) who underwent CAG , 15 (9,5%) developed CIN . The volume administered of contrast was not related to the existence of postprocedure CIN (96,6±35,9 ml vs 102,5±33,7ml , p=0,16). However , it was associated with a higher incidence of CIN in patients with chronic renal failure (90±19,1 ml vs 116,6±73,7ml , p=0,008) . The mean V/eGFR value was 1,2±0,7.Nine percent of patients exceeded the toxic contrast dose. After adjusting for other known predictors of CIN, a V/eGFR ratio &gt; 2 remained significantly associated with CIN (odds ratio 4.7, 95% confidence interval 1.28-17.7, P=0,02). Conclusion Low incidences of CIN suggest that a reduced dose of contrast agent is safe in high-risk patients with impaired renal function. A ratio volume of contrast media to estimated glomerular filtration rate &gt; 2 is a significant and independent predictor of CIN after CAG.

scholarly journals Estimated glomerular filtration rate and postoperative mortality in patients undergoing non-cardiac and non-neuron surgery: a single-center retrospective study

2020 ◽  
Author(s):  
Xueying Luo ◽  
Sujing Zheng ◽  
Baoer Liu ◽  
Liping Yang ◽  
Ya Li ◽  
...  
Keyword(s):  
Glomerular Filtration Rate ◽  
Glomerular Filtration ◽  
Odds Ratio ◽  
Filtration Rate ◽  
Inflection Point ◽  
Estimated Glomerular Filtration Rate ◽  
Multivariate Logistic Regression Analysis ◽  
Postoperative Mortality ◽  
Ratio Test ◽  
Clinical Records

Abstract Background：There is limited evidence to clarify the specific relationship between preoperative estimated glomerular filtration rate (preop-eGFR) and postoperative thirty-day mortality in Asian patients undergoing non-cardiac and non-neuron surgery. We aimed to investigate details of this relationship.Methods：We reanalyzed a retrospective analysis of the clinical records of 90,785 surgical patients at the Singapore General Hospital from January 1, 2012 to October 31, 2016. The main outcome was postoperative thirty-day mortality.Results ：The average age of these recruited patients was 53.96 ± 16.88 years, of which approximately 51.64% were female. The mean of preop-eGFR distribution was 84.45 ± 38.56mL/min/1.73m2. Multivariate logistic regression analysis indicated that preop-eGFR was independently associated with thirty-day mortality (adjusted odds ratio: 0.992; 95% confidence interval [CI]: 0.990-0.995; P < 0.001). A U-shaped relationship was detected between preop-eGFR and thirty-day mortality with an inflection point of 98.688(P for log likelihood ratio test <0.001). The effect sizes and confidence intervals on the right and left sides of the inflection point were 1.013 (1.007 to 1.019) [P < 0.0001] and 0.984 (0.981 to 0.987) [P < 0.0001], respectively. Preoperative comorbidities such as congestive heart failure (CHF), type 1 diabetes, ischemic heart disease (IHD),and anemia were associated with the odds ratio of preop-eGFR to thirty-day mortality (interaction P < 0.05).Discussion：The relationship between preop-eGFR and thirty-day mortality is U-shaped. The recommended preop-eGFR at which the rate of the thirty-day mortality was lowest was 98.688mL/min/1.73m2.

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