Oweis Ashraf O, Alshelleh Sameeha A, Daoud Ammar K, Smadi Mahmoud M, Alzoubi Karem H
Department of Internal Medicine, Jordan University of Science and Technology, Irbid, Jordan,
Department of Internal Medicine, the University of Jordan, Amman, Jordan.
Int J Nephrol Renovasc Dis. 2018 Aug 13;11:211-215. doi: 10.2147/IJNRD.S171930. eCollection 2018.
Acute kidney injury (AKI) caused by contrast exposure is a common problem, which may cause a significant increase in patients in-hospital stay and therefore the cost of treatment. This study was conducted to evaluate the role of inflammation, inflammatory markers in predicting contrast induced nephropathy (CIN). This is a prospective study that was carried out in a major tertiary referral hospital in Jordan.
Clinical data, blood and urine samples were collected from all patients admitted to the cardiology unit. All patients who agreed to participate in the study had creatinine level analysis 48-72 hours after the procedure. The CIN was defined as an increase in serum creatinine by 25% or 44 μmol/L from the baseline within 48-72 hours after the contrast administration. Patients with stage 4, 5 renal failure, patients on dialysis, and patients with recent intravenous contrast use, active infection or cancer were excluded from the study.
Of the total 202 patients, 30 (14.8%) developed CIN. The incidence rate was 21.1% among females and 12.4% among males. In the multivariate analysis, beside eGFR, diuretics, and alkaline phosphatase, IL-33 was significantly associated with CIN, while the other cytokines did not to show this an association.
Serum level of IL-33 was a significant predictor for development of CIN. Good clinical judgment and high serum levels of IL-33 may stratify patients into low and high risk for CIN.
造影剂暴露所致急性肾损伤（AKI）是一个常见问题，可能导致患者住院时间显著延长，进而增加治疗费用。本研究旨在评估炎症及炎症标志物在预测造影剂肾病（CIN）中的作用。这是一项在约旦一家大型三级转诊医院开展的前瞻性研究。
收集心内科所有住院患者的临床资料、血液和尿液样本。所有同意参与研究的患者在术后48 - 72小时进行肌酐水平分析。CIN定义为造影剂注射后48 - 72小时内血清肌酐较基线水平升高25%或44 μmol/L。4期、5期肾衰竭患者、透析患者以及近期使用过静脉造影剂、有活动性感染或癌症的患者被排除在研究之外。
在总共纳入的202例患者中，30例（14.8%）发生了CIN。女性发病率为21.1%，男性为12.4%。在多因素分析中，除估算肾小球滤过率（eGFR）、利尿剂和碱性磷酸酶外，白细胞介素-33（IL-33）与CIN显著相关，而其他细胞因子未显示出这种相关性。
血清IL-33水平是CIN发生的重要预测指标。良好的临床判断和高血清IL-33水平可将患者分为CIN的低风险和高风险人群。
