Abstract 13433: Predictors of Contrast Induced Nephropathy in Patients With Acute Coronary Syndromes and Normal Baseline Glomerular Filtration Rate

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Daniel Negreanu ◽  
Michael Gagnon ◽  
anh nguyen ◽  
Samer Mansour ◽  
Michel T Nguyen ◽  
...  
Keyword(s):  
Glomerular Filtration Rate ◽  
Serum Creatinine ◽  
Glomerular Filtration ◽  
Acute Coronary Syndromes ◽  
Filtration Rate ◽  
Fold Increase ◽  
Contrast Induced Nephropathy ◽  
Baseline Serum ◽  
Coronary Syndromes ◽  
The Mean

Background: The incidence and predictors of contrast-induced nephropathy (CIN) in patients with normal glomerular filtration rate (GFR) are not well ascertained. We aim to determine the incidence and predictors for CIN after coronary catheterization (CATH) for acute coronary syndromes (ACS). Methods: We combined the datasets of two studies. The AMI-QUEBEC was an observational cohort of patients with ST-segment elevation myocardial infarctions in 2003. The AMI-OPTIMA was a study of patients hospitalized with ACS in 2009 and 2012. For this analysis, we retained only patients with GFR > 60 ml/min who underwent CATH. We defined “hyperfiltrators” as patients with GFR above the 95th percentile age and sex-adjusted value. CIN was defined as an increase in serum creatinine >0.5 mg/dL (44.2 μmols/L) or > 50% from baseline serum creatinine. Results: There were 3,188 patients with GFR > 60 ml/min : 39 hyperfiltrators and 3,149 without hyperfiltration. The mean age was similar between the two groups of patients (62 years); 21% and 27% females in hyperfiltrators and non-hyperfiltrators (p<0.0001). The prevalences of diabetes mellitus and hypertension were 36% and 64%, respectively in hyperfiltrators compared to 20% and 46%, respectively in non-hyperfiltrators. The mean baseline GFR and creatinine were 112 ml/min and 50 μmols/L, respectively in hyperfiltrators; 84.2 ml/min and 80 μmols/L in non-hyperfiltrators. There were 225 CIN following CATH; 7.1% of the whole cohort with 35.9% in the hyperfiltrators and 6.7% in non-hyperfiltrators. Hyperfiltration was independently associated with a 13-fold increase in the risk of CIN (Table 1). Each year of increase in age was associated with a 5% increase in the risk of CIN. Shock was also associated with an 11-fold increase in the risk of CIN. Conclusion: Hyperfiltrators may be at high risk of CIN following CATH in ACS. The risk of CIN associated with hyperfiltration should be evaluated in other populations.

Change in Glomerular Filtration Rate with Febuxostat in Patients with Advanced Chronic Renal Failure

2021 ◽  
Vol 15 (11) ◽  
pp. 3293-3295
Author(s):  
Ishtiaq Alam ◽  
Faheem Usman Sulehri ◽  
Muhammad Abdul Azim Baig ◽  
Maira Bhatti ◽  
Fouzia Perveen ◽  
...  
Keyword(s):  
Glomerular Filtration Rate ◽  
Kidney Disease ◽  
Serum Creatinine ◽  
Serum Creatinine Level ◽  
Glomerular Filtration ◽  
Filtration Rate ◽  
Estimated Glomerular Filtration Rate ◽  
Mean Value ◽  
Kidney Dysfunction ◽  
The Mean

Background: Chronic kidney disease (CKD), is defined as progressive loss in kidney function. The study evaluated the mean change in estimated glomerular filtration rate (eGFR) with febuxostat in patients of advanced chronic kidney dysfunction with hyperuricemia. Methodology: A prospective observational study was conducted at the department of Nephrology, Sheikh Zayed Hospital, Lahore for 6 months, from January 2019 to October 2019. At baselines, the blood sample was obtained and sent to the laboratory for assessment of serum creatinine level. The eGFR was calculated by using the MDRD formula. Patients were then advised to take one oral Febuxostat 40 mg daily for 6 months. After 6 months, the blood sample was obtained for assessment of serum creatinine level. Results: The mean age of the patients was 40.72±14.90 years, male to female ratio was 1:1. The mean value of eGFR at baseline was 23.53±11.09 and its mean value at 6th month was 34.28+12.31, which was significant (p<0.001). Conclusion: Febuxostat effectively improved estimated glomerular filtration rate (eGFR) in patients presenting with advanced chronic kidney dysfunction with hyperuricemia. Keywords: Hyperuricemia, Kidney, Disease, Febuxostat, Dysfunction, Glomerular, Filtration

scholarly journals Effect of pre-eclampsia on glomerular filtration rate in Sudanese women

2017 ◽  
Vol 5 (3) ◽  
pp. 1053 ◽  
Author(s):  
Hind Mamoun Beheiry ◽  
Ibrahim Abdelrhim Ali ◽  
Duria A. M. Rayis ◽  
Amal M Saeed
Keyword(s):  
Glomerular Filtration Rate ◽  
Serum Creatinine ◽  
Creatinine Clearance ◽  
Glomerular Filtration ◽  
Filtration Rate ◽  
Normal Pregnancy ◽  
Maternity Hospital ◽  
Urine Creatinine ◽  
The Mean ◽  
Control Study

Background: Creatinine clearance is safest method to measure glomerular filtration rate (GFR) in pregnancy. The objectives was to study a case-control study conducted in Omdurman Maternity Hospital aimed to assess GFR, using creatinine clearance and magnitude of changes of serum creatinine in pre-eclampsia.Methods: Pre-eclamptic were 70, normal pregnant 96 and non-pregnant 63. Investigations were done at St Hellier's hospital London. Serum and urine creatinine were measured using Jaffé reaction and spectrophotometer. 24-hour urine output was measured and creatinine clearance calculated to find GFR. GFR was calculated in ml/min/mm2 using John Hopkins’ method.Results: The mean serum creatinine in pre-eclamptic (68.6µmol/L) was less than non-pregnant (75.5µmol/L) (P=0.001) but was higher than normal pregnant (62.4µmol/L) (P=0.003). Mean GFR pre-eclamptic (68.6ml/min.1.73m2) was less than non-pregnant (87.0ml/min/1.73m2) (P=0.0001) and normal pregnant (89.0ml/min/1.73ml/min/1.73m2) (P =0.0001).Conclusions: GFR decreased at term in normal pregnancy and even more in pre-eclampsia. Serum creatinine levels increased and did not correlate with GFR changes in pre-eclampsia.

scholarly journals Accuracy of commonly used equations for estimating glomerular filtration rate in Nepalese population

2012 ◽  
Vol 1 (2) ◽  
pp. 52-55
Author(s):  
Anil Baral ◽  
Kiran Manandhar ◽  
Rajani Hada ◽  
Rajendra Kumar Agrawal ◽  
Ajay Rajbhandari
Keyword(s):  
Internal Medicine ◽  
Glomerular Filtration Rate ◽  
Renal Disease ◽  
Serum Creatinine ◽  
Glomerular Filtration ◽  
Filtration Rate ◽  
Coefficient Of Determination ◽  
Different Populations ◽  
The Mean ◽  
Measured Gfr

Introduction - Estimation of glomerular filtration is of utmost importance in clinical practice. Various equations have been developed in different populations based on serum creatinine. These equations have not yet been validated in the Nepalese population. This study was conducted to compare the accuracy Cockcroft Gault and Modification of Diet in Renal Disease equations for estimating the glomerular filtration rate in Nepalese population. Methods - A total of 100 patients with chronic kidney disease were included in the study. Fifty patients had serum creatinine less than 1.5 mg/dl and 50 patients had serum creatinine more than or equal to 1.5 mg/dl. Glomerular Filtration Rate was measured as creatinine clearance from 24 hour timed urinary collections and estimated using both the Cockcroft-Gault and Modification of Diet in Renal Disease equations for all the patients. The degree of accuracy of each equation was calculated by the coefficient of determination(R2). Results - The mean glomerular filtration rate estimated from the Cockcroft Gault equation was 51.29 ml/min/1.73sqm and mean glomerular filtration rate estimated from the Modification of Diet in Renal Disease equation was 48.41 ml/min/1.73sqm whereas the mean measured GFR was 53.30ml/ min/1.73sqm. The coefficient of determination (R2) was calculated for both the equations. The Cockcroft Gault equation was more accurate in the Nepalese population (R2=0.88) than the Modification of Diet in Renal Disease equation whose coefficient of determination was 0.84. Conclusions - In the Nepalese population the Cockcroft Gault equation was more accurate in estimating the glomerular filtration rate in comparison to the Modification of Diet in Renal Disease equation . DOI: http://dx.doi.org/10.3126/jaim.v1i2.6503 Journal of Advances in Internal Medicine 2012;01(02):52-3

scholarly journals Lack of Effect of DX-619, a Novel Des-Fluoro(6)-Quinolone, on Glomerular Filtration Rate Measured by Serum Clearance of Cold Iohexol

2007 ◽  
Vol 51 (6) ◽  
pp. 1912-1917 ◽  
Author(s):  
Nenad Sarapa ◽  
Prachi Wickremasingha ◽  
NanXiang Ge ◽  
Richard Weitzman ◽  
Merynda Fuellhart ◽  
...  
Keyword(s):  
Glomerular Filtration Rate ◽  
Serum Creatinine ◽  
Healthy Volunteers ◽  
Glomerular Filtration ◽  
Filtration Rate ◽  
Serum Creatinine Concentration ◽  
Bacterial Strains ◽  
Creatinine Concentration ◽  
Significant Difference ◽  
The Mean

ABSTRACT DX-619 is a novel des-fluoro(6)-quinolone with activity against a broad range of bacterial strains, including methicillin-resistant Staphylococcus aureus. The effects of DX-619 on the glomerular filtration rate (GFR) were evaluated because drug-related increases in serum creatinine levels were observed in studies with healthy volunteers. Forty-one healthy subjects were randomized to receive intravenous DX-619 at 800 mg or placebo once daily for 4 days, and the GFR was directly measured by determination of the clearance of a bolus iohexol injection in 33 subjects who completed the study per protocol. DX-619 was noninferior to placebo for the GFR on the basis of a criterion for a clinically significant difference of −12 ml/min/1.73 m2. The mean GFRs on day 4 were 101.1 ± 14.2 ml/min/1.73 m2 and 100.2 ± 15.6 ml/min/1.73 m2 for the volunteers receiving placebo and DX-619, respectively. On day 4 the mean serum creatinine concentration for volunteers receiving DX-619 increased by 30 to 40%, with a corresponding decrease in mean creatinine clearance. Both parameters normalized within 7 days after the cessation of DX-619 treatment. Nonclinical studies suggest that DX-619 increases the serum creatinine concentration by inhibiting excretory tubular transporters. In conclusion, DX-619 administered intravenously at 800 mg once a day for 4 days did not affect the GFR in healthy volunteers. Glomerular toxicity is not expected to present a risk to patients receiving DX-619 in clinical trials, but monitoring of the renal function, with an emphasis on the serum creatinine concentration, is still warranted.

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