Effect of Contrast Agent on Renal Functions in Patients with Renal Impairment Undergoing Percutaneous Coronary Intervention
Ramzy Hamed El Mawardy, Haytham Galal Mohamed Helmy, Eslam Adel Mohamed Azab- General Medicine
Abstract
Background
Contrast induced nephropathy is one of the most important clinical complications associated with IV administration of radio-contrast media. This prospective study evaluating incidence and predictors of contrast induced nephropathy after administration of contrast agent in patients with renal impairment undergoing percutaneous coronary intervention.
Objective
To predict the effect of contrast agents on renal functions in patients with renal impairment undergoing percutaneous coronary intervention.
Patients and Methods
A prospective study that included 120 patients who underwent percutanous coronary intervention with glomerular filtration rate below 90 ml/min. All patients were subjected to full history, examination and investigation. Results were recorded using serum creatinine and glomerluar filtration rate before and 72 hours after procedure.
Results
CIN had occurred in 26.67% of studied group where these was high incidence of occurrence of CIN with elderly (p = 0.009), obese patients (p = 0.039), hypertensive (p = 0.004), Diabetics (p = 0.000) and amount of dye received (p = 0.000). 50% of patients who developed CIN where males and 50% where females which was non significant with p = 0.165.
Conclusion
CIN in patients with preexisting renal damage or risk factors for the development of kidney dysfunction is a potentially serious complication after PCI with increased short and longterm morbidity and mortality. Appropriate management of patients at risk is crucial for the prevention of CIN. Although a specific treatment for CIN is not available removal of modifiable risk factors and implementation of periprocedural measures such as CM reduction and intravenous hydration can significantly lower the risk of CIN in selected patients.