Suresh H1, Anup Hanchinal2
BACKGROUND
Contrast-Induced Nephropathy (CIN), a disorder of renal function is next only to surgery and hypotension in causing acute renal failure (Acute kidney injury) in hospitalised patients. CIN is one of the main reasons for morbidity and mortality in these patients as iodinated contrast media is being used increasingly in diagnostic imaging and interventional procedures coronary angiography.
MATERIALS AND METHODS
100 patients with ischemic heart disease who underwent coronary interventional procedures in KIMS, Hubli from 1st January 2016 to 30th June 2016 were included in the study. Clinical evaluation with progress of acute kidney injury and recovery was studied.
RESULTS
Incidence of CIN in this study was 9%. Patients with age more than 50 years had comparatively higher incidence of CIN (12.1%) compared to a 4.8% in age less than 50 years group. Male patients had higher incidence of CIN (10.6%) as compared to females (5.9%). In the study group of 100 patients, 21% of total diabetic patients developed CIN (p=0.041). 23.5% of total hypertensive patients developed CIN (p=0.000). 23.5% of the total anaemic patients developed CIN (p<0.05). Among ACS (acute coronary syndrome) patients, STEMI (ST ELEVATION MI) patients had higher incidence of CIN (21.74%) compared to 5.19% in NSTEMI/UA (UNSTABLE ANGINA) patients (p<0.05). Mean ejection fraction (EF) was comparatively lower in CIN group than in non-CIN patients though statistically not significant with p>0.05. Among the patients who developed CIN, regional wall motion abnormality (RWMA) was frequently noted in the LAD (left anterior descending) territory. Most common culprit vessel involved in CIN patients was LAD followed by LCA (left circumflex artery) and RCA (right circumflex artery). Out of 9 CIN patients, 5 patients had double vessel disease and one patient had triple vessel disease. CIN patients were followed up for 7 days. Serum creatinine levels returned to normal values in all the patients. None of the patients required dialysis.
CONCLUSION
The incidence of CIN is 9%. Age more than 50 years (12.1%), hypertension (23.5%), diabetes (21.1%) and anaemia (23.5%) are major risk factors in contributing to the development of CIN. Patients with multivessel involvement and proximal LAD disease along with above-mentioned risk factors are at greater risk for CIN.
