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Abstract

Incidence and Predictors of Contrast-induced Nephropathy in Patients Undergoing Percutaneous Coronary Interventions at an Indian Tertiary Care Center

Author(s): Maneesha Sasidharan, E. James* and J. C. Menon1
Department of Pharmacy Practice, Amrita School of Pharmacy, 1Department of Adult Cardiology, Amrita Institute of Medical Sciences, Amrita Vishwa Vidyapeetham, AIMS Health Science Campus, Ponekkara, Kochi-682 041, India

Correspondence Address:
Department of Pharmacy Practice, Amrita School of Pharmacy, Amrita Institute of Medical Sciences, Amrita Vishwa Vidyapeetham, AIMS Health Science Campus, Ponekkara, Kochi-682 041, India


This investigation is aimed to assess the incidence and possible risk factors of contrast-induced nephropathy and also the utility of Mehran risk score for prediction of contrast-induced nephropathy in patients undergoing percutaneous coronary interventions. A cross-sectional observational study was conducted on 480 patients who underwent percutaneous coronary interventions. Patients with and without contrast-induced nephropathy were evaluated to recognize the predictive factors of contrast-induced nephropathy and explored the benefit of Mehran’s risk score for prediction of contrast-induced nephropathy using receiver operating characteristics curve, Youden’s index and a likelihood ratio test. The incidence of contrast-induced nephropathy was 5.2 % (95 % confidence interval- 4.75¬ to 5.65). The associated risk factors were diabetes mellitus, hypertension, age >75 years and contrast volume ≥100 ml (p>0.001). Multivariate analysis identified age >75 years and hypertension as independent risk factors. Low Mehran risk category (score <5) patients had a higher occurrence (56 %) of contrast-induced nephropathy compared to other Mehran risk groups. Mehran risk scoring had high sensitivity (63.1 %) and low specificity (44 %) which was affirmed by Youden’s index (0.071) and an area under the receiver operating characteristics curve of 0.592. Contrast-induced nephropathy is a possible risk factor for all patients undergoing percutaneous coronary interventions. Contrast volume ≥100 ml, age >75 years, diabetes mellitus and hypertension were the predictors of contrast-induced nephropathy. Mehran risk score appeared irrelevant in stratifying the risk of contrast-induced nephropathy in patients undergoing percutaneous coronary interventions.



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