Abstract: TH-PO077
Impact of Contrast Media Volume on the Onset of Contrast-Induced Nephropathy During Coronary Angiography: A Retrospective Study
Session Information
- AKI: Epidemiology, Risk Factors, Prevention - I
November 07, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Acute Kidney Injury
- 101 AKI: Epidemiology, Risk Factors, and Prevention
Author
- Pozdzik, Agnieszka, Centre Hospitalier Universitaire, Brugmann Hospital,, Brussels, Belgium
Group or Team Name
- Nephrology and Dialysis Clinic, Centre Hospitalier Universitaire, Brugmann, Hospital, Brussels, Belgium and Cardiology Department, Centre Hospitalier Universitaire, Brugmann, Hospital, Brussels, Belgium
Background
Contrast media administration after coronary angiography can be complicated by a contrast-induced nephropathy (CIN). The toxicity threshold volume of contrast media remains undefined. The objective is to study (1) the relationship between the volume of injected contrast media and the occurrence of CIN and (2) the existence of a possible formula to calculate the threshold volume of toxicity of the contrast media for each patient after acute percutaneous coronary intervention.
Methods
We performed a retrospective study in 4773 patients who received percutaneous coronary intervention for acute coronary syndrome between 2012 and 2018. Contrast-induced nephropathy was defined as an increase of ≥ 0.5 mg/dL or ≥ 25% of serum creatinine compared to its baseline value between the 1st and 10th day following contrast media injection. Predictive factors independent of CIN adjusted to their observed mean was introduced into the formula calculate the threshold volume for renal toxicity.
Results
Of the 3073 patients analysed, 724 (23.6%) developed CIN.
In our population, age, diabetes, PC volume, basal CrS and basal DFG are independent predictors of CIN, the risk of CIN is lower in men. Diabetes almost doubles the risk of NIC. A positive correlation was found between the volume of contrast media and the variation of basal serum creatinine. Patients receiving a higher amount of contrast media are significantly more likely to develop nephropathy (p<0.001). The volume of contrast media is an independent predictive factor of the occurrence of contrast nephropathy. We have developed a threshold volume prediction formula with a negative predictive value of 82%.
Conclusion
The volume of contrast media influences the occurrence of CIN. Therefore, there is an interest in reducing the amount of injected contrast during the intervention despite a weak relationship. A toxic PC volume threshold is difficult to establish given the different factors involved in the development of CIN. Nevertheless, the proposed formula could provide an additional tool for optimizing the prevention of renal toxicity.