Contrast induced nephropathy natural history, complications and prognosis
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mohamed Moubarak, M.D. [2]
Overview
The reported incidence varies widely according to the presence or absence of risk factors, and usually associated with a significantly higher risk of in-hospital and 1-year mortality, even in patients who do not need dialysis.
Natural history, Complications and Prognosis
Studies have substantiated greater all-cause and cardiovascular mortality[1], prolonged duration of hospitalization[2], and late cardiovascular events[3] associated with CIN. The evidence is seen mostly in patients undergoing PCI.[4][5] Weisbord et al showed that an absolute increase in serum creatinine of 0.25 to 0.5 mg/dL within 72 hours after coronary angiography was associated with significantly greater odds for in-hospital mortality in the 30 day period following the procedure.[5] The need for dialysis following CIN is also a separate prognostic indicator. Dialysis requirement has been associated with a fivefold increase in all-cause mortality when compared to patients with CIN not requiring renal replacement. Furthermore, mortality in the former group was as high as 81% at 2 years.[6]
References
- ↑ Marenzi G, Lauri G, Assanelli E, Campodonico J, De Metrio M, Marana I; et al. (2004). "Contrast-induced nephropathy in patients undergoing primary angioplasty for acute myocardial infarction". J Am Coll Cardiol. 44 (9): 1780–5. doi:10.1016/j.jacc.2004.07.043. PMID 15519007.
- ↑ McCullough PA, Sandberg KR (2003). "Epidemiology of contrast-induced nephropathy". Rev Cardiovasc Med. 4 Suppl 5: S3–9. PMID 14668704.
- ↑ McCullough PA, Adam A, Becker CR, Davidson C, Lameire N, Stacul F; et al. (2006). "Epidemiology and prognostic implications of contrast-induced nephropathy". Am J Cardiol. 98 (6A): 5K–13K. doi:10.1016/j.amjcard.2006.01.019. PMID 16949375.
- ↑ McCullough PA (2008). "Radiocontrast-induced acute kidney injury". Nephron Physiol. 109 (4): p61–72. doi:10.1159/000142938. PMID 18802377.
- ↑ 5.0 5.1 Weisbord SD, Chen H, Stone RA, Kip KE, Fine MJ, Saul MI; et al. (2006). "Associations of increases in serum creatinine with mortality and length of hospital stay after coronary angiography". J Am Soc Nephrol. 17 (10): 2871–7. doi:10.1681/ASN.2006030301. PMID 16928802.
- ↑ McCullough PA, Wolyn R, Rocher LL, Levin RN, O'Neill WW (1997). "Acute renal failure after coronary intervention: incidence, risk factors, and relationship to mortality". Am J Med. 103 (5): 368–75. PMID 9375704.