Department of Vascular Surgery, 9898University Hospitals of North Midlands NHS Trust, UK.
Department of Renal Medicine, Royal Free & University College Medical School and Royal Free Hospital, London, UK.
Angiology. 2021 Mar;72(3):274-278. doi: 10.1177/0003319720969536. Epub 2020 Nov 24.
Contrast-induced nephropathy (CIN) is common. Risk factors include preexisting renal impairment, diabetes, elderly age, and dehydration. In a single-centre prospective study, we investigated which factors are implicated for CIN in patients with peripheral arterial disease due for angiography. Serum creatinine was measured before, 1, 2, and 7 days post-angiography. We also considered the chronic kidney disease stage of the patients at admission and 48 hours post-contrast. All patients received 500 mL normal saline pre- and post-angiography and a low-osmolality contrast medium. 6 of 94 patients developed CIN: 1 required dialysis and 1 died partly due to renal failure. Only 2 factors were associated with CIN: body mass index (BMI; = .019) and kidney function ( = .001); 4 of 6 patients with CIN were obese (BMI ≥30) and only 2 were nonobese ( = .0092). Diabetes, contrast volume, and age were not significant risk factors. Our results confirm renal impairment raises the risk of CIN. To our knowledge, we report for the first time that obesity may be a risk factor for CIN. Pending confirmatory studies and given the rising prevalence of obesity, this finding could help identify at-risk patients and hence reduce the burden of CIN.
对比剂肾病（CIN）很常见。危险因素包括：原有肾脏损害、糖尿病、老年和脱水。在一项单中心前瞻性研究中，我们研究了因血管造影而患有外周动脉疾病的患者中哪些因素与 CIN 相关。在血管造影前、后第 1、2 和 7 天测量血清肌酐。我们还考虑了患者入院时和造影后 48 小时的慢性肾脏病分期。所有患者在血管造影前后均接受 500mL 生理盐水，并使用低渗透压造影剂。94 例患者中有 6 例发生 CIN：1 例需要透析，1 例部分因肾衰竭死亡。只有 2 个因素与 CIN 相关：体重指数（BMI； =.019）和肾功能（ =.001）；6 例 CIN 患者中有 4 例肥胖（BMI≥30），仅有 2 例非肥胖（ =.0092）。糖尿病、造影剂用量和年龄不是显著的危险因素。我们的结果证实肾功能损害会增加 CIN 的风险。据我们所知，我们首次报告肥胖可能是 CIN 的一个危险因素。在确认性研究进行之前，鉴于肥胖的患病率不断上升，这一发现可以帮助识别高危患者，从而降低 CIN 的负担。
