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冠状动脉造影检查的肾功能正常患者中对比剂诱导的肾病

Contrast induced nephropathy among patients with normal renal function undergoing coronary angiography.

作者信息

Assareh Ahmadreza, Yazdankhah Saeed, Majidi Shahla, Nasehi Nasim, Beladi Mousavi Seyed Seifollah

机构信息

Department of Cardiology, Faculty of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.

Chronic Renal Failure Research Center, Faculty of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.

出版信息

J Renal Inj Prev. 2016 Feb 26;5(1):21-4. doi: 10.15171/jrip.2016.05. eCollection 2016.

Abstract

INTRODUCTION

Although contrast induced nephropathy (CIN) is a well-known complication of radiocontrast media administration among patients with underlying renal insufficiency, however the data about CIN among patients with normal renal function are few and it seems that CIN often remained under-diagnosed among these patients.

OBJECTIVES

The aim of present study was evaluation of CIN in diabetic and nondiabetic patients with normal renal function undergoing coronary angiography.

PATIENTS AND METHODS

This cross-sectional and prospective study has conducted on patients with normal renal function candidate for diagnostic coronary angiography at Imam hospital, Ahvaz, Iran from October 2010 to February 2011. CIN defined as an increase in serum creatinine (sCr) >0.5 mg/dL after two days of contrast administration. A standardized questionnaire was used to collect demographics, clinical and laboratory data.

RESULTS

A total of 254 patients (140 males and 114 Females with mean age of 56.6 ± 11.9 years) were included in the study. Of them, 60 patients (23.6%) had congestive heart failure (CHF) and 57 patients (22.4%) had diabetes mellitus (DM). The mean sCr levels before contrast administration in men and women were 1.05 ± 0.22 and 0.93 ± 0.17 mg/dL respectively. In overall CIN occurred in 27 patients (10.6%) with no difference between males and females (P = 0.386) and in patients with or without CHF (P = 0.766). There was a significant association between CIN and DM (P = 0.001) and mean volume of contrast administration (P = 0.001).

CONCLUSION

Although CIN is a common problem in patients with diabetic nephropathy undergoing coronary angiography, diabetic patients without diabetic nephropathy and also patients without DM who had normal renal function are also at risk of contrast nephropathy.

摘要

引言

尽管造影剂肾病(CIN)是肾功能不全患者接受放射性造影剂注射后一种广为人知的并发症,然而关于肾功能正常患者中CIN的数据却很少,而且似乎在这些患者中CIN常常未被充分诊断。

目的

本研究旨在评估接受冠状动脉造影的肾功能正常的糖尿病和非糖尿病患者中的CIN。

患者与方法

本横断面前瞻性研究于2010年10月至2011年2月在伊朗阿瓦士伊玛目医院对拟接受诊断性冠状动脉造影的肾功能正常患者进行。CIN定义为造影剂注射两天后血清肌酐(sCr)升高>0.5mg/dL。使用标准化问卷收集人口统计学、临床和实验室数据。

结果

本研究共纳入254例患者(140例男性和114例女性,平均年龄56.6±11.9岁)。其中,60例患者(23.6%)患有充血性心力衰竭(CHF),57例患者(22.4%)患有糖尿病(DM)。造影剂注射前男性和女性的平均sCr水平分别为1.05±0.22和0.93±0.17mg/dL。总体而言,27例患者(10.6%)发生了CIN,男性和女性之间无差异(P = 0.386),有或无CHF的患者之间也无差异(P = 0.766)。CIN与DM(P = 0.001)和造影剂平均注射量(P = 0.001)之间存在显著关联。

结论

尽管CIN是接受冠状动脉造影的糖尿病肾病患者中的常见问题,但无糖尿病肾病的糖尿病患者以及肾功能正常的非糖尿病患者也有发生造影剂肾病的风险。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/856c/4827381/8d789479832c/jrip-5-21-g001.jpg

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