Department of Cardiology, Affiliated Hospital of Xuzhou Medical College, No. 99 Huihai west Road, Xuzhou, 221002, China.
Int Urol Nephrol. 2013 Aug;45(4):1065-70. doi: 10.1007/s11255-012-0340-8. Epub 2012 Dec 7.
The aim of the present study was to assess the influence of anemia on the risk of developing contrast-induced nephropathy after percutaneous coronary angioplasty.
Serum creatinine values were measured before and within 48 h after the administration of contrast agents. Contrast-induced nephropathy (CIN) was defined as an increase of ≥ 0.5 mg/dl or ≥ 25 % in serum creatinine concentration over baseline within 48 h after administration. Anemia was defined as hemoglobin <120 g/l in women and <130 g/l in men.
Among the 1,026 patients studied, 32 (3.1 %) developed CIN after procedure. CIN occurred in 6.3 % of the anemic patients and in 2.2 % of the non-anemic patients (P < 0.01). The incidence of CIN increased with decreasing of baseline estimated glomerular filtration rate (eGFR) in both the anemia and non-anemia groups. In patients with baseline eGFR <30 ml/min, a high proportion of both anemic and non-anemic patients experienced CIN (24.6 vs. 17.5 %). When baseline eGFR was 30-59 ml/min, the incidence of CIN in anemic patients was twofold higher than in non-anemic patients (7.9 vs. 3.8 %; P < 0.05). Multivariate logistic regression analysis found that baseline eGFR and baseline hemoglobin were independent predictors of CIN.
Anemia is associated with a higher incidence of CIN in patients with moderate renal dysfunction. Patients with both preexisting renal insufficiency and anemia are at high risk of CIN. Baseline eGFR and baseline hemoglobin are independent predictors of CIN.
本研究旨在评估贫血对经皮冠状动脉介入治疗后对比剂诱导肾病（CIN）风险的影响。
在给予对比剂前后 48 小时内测量血清肌酐值。CIN 定义为在给予对比剂后 48 小时内血清肌酐浓度较基线升高≥0.5mg/dl 或≥25%。贫血定义为女性血红蛋白<120g/l，男性血红蛋白<130g/l。
在 1026 名研究患者中，32 名（3.1%）在手术后发生 CIN。贫血患者 CIN 的发生率为 6.3%，非贫血患者为 2.2%（P<0.01）。在贫血和非贫血组中，CIN 的发生率随着基线估算肾小球滤过率（eGFR）的降低而增加。在基线 eGFR<30ml/min 的患者中，贫血和非贫血患者均有较高比例发生 CIN（24.6% vs. 17.5%）。当基线 eGFR 为 30-59ml/min 时，贫血患者的 CIN 发生率是非贫血患者的两倍（7.9% vs. 3.8%；P<0.05）。多变量逻辑回归分析发现，基线 eGFR 和基线血红蛋白是 CIN 的独立预测因子。
在肾功能中度受损的患者中，贫血与 CIN 的发生率较高相关。同时存在预先存在的肾功能不全和贫血的患者发生 CIN 的风险很高。基线 eGFR 和基线血红蛋白是 CIN 的独立预测因子。
