Department of Endocrinology, School of Medicine, Harran University, Sanliurfa, Turkey.
Department of Internal Medicine, School of Medicine, Harran University, Sanliurfa, Turkey.
Angiology. 2023 Aug;74(7):624-630. doi: 10.1177/00033197231155581. Epub 2023 Feb 6.
The occurrence of contrast-associated acute kidney injury (CA-AKI) is influenced by both patient-related and contrast-related factors. More specifically, CA-AKI has been linked to renal dysfunction, diabetes mellitus (DM), and atherosclerotic cardiovascular diseases (ASCVD). We hypothesized that the prevalence of CA-AKI was high in patients with diabetic foot ulcers (DFU) because they frequently have several ASCVD risk factors and additional comorbid conditions (including ASCVD). We retrospectively examined the medical records of 208 type 2 diabetic patients who were hospitalized for DFU. These patients were divided into two groups: group 1 included 107 patients who underwent contrast-enhanced computed tomographic angiography (CTA); group 2 (control group) included 101 patients who did not receive contrast media. Following CTA, 13 (12.1%) patients developed CA-AKI in group 1, while 3 (3.0%) patients in group 2 had serum creatinine elevations consistent with AKI ( = 0.013). The following risk factors for CA-AKI were identified: longer history of DM, higher baseline serum creatinine, congestive heart failure, Wagner stage 4 and 5 DFUs, peripheral artery disease, older age, and lower hemoglobin values. CA-AKI is a common complication after CTA in patients with DFU. To reduce the risk of CA-AKI in these patients, associated risk factors and preventive measures should be considered.
对比剂相关急性肾损伤(CA-AKI)的发生受患者相关和对比剂相关因素的影响。更具体地说,CA-AKI 与肾功能障碍、糖尿病(DM)和动脉粥样硬化性心血管疾病(ASCVD)有关。我们假设糖尿病足溃疡(DFU)患者的 CA-AKI 患病率较高,因为他们通常有多种 ASCVD 危险因素和其他合并症(包括 ASCVD)。我们回顾性检查了 208 例因 DFU 住院的 2 型糖尿病患者的病历。这些患者分为两组:组 1 包括 107 例接受对比增强 CT 血管造影(CTA)的患者;组 2(对照组)包括 101 例未接受造影剂的患者。在 CTA 后,组 1 中有 13 例(12.1%)患者发生 CA-AKI,而组 2 中有 3 例(3.0%)患者出现与 AKI 一致的血清肌酐升高(=0.013)。确定了 CA-AKI 的以下危险因素:DM 病史较长、基线血清肌酐较高、充血性心力衰竭、Wagner 4 期和 5 期 DFU、外周动脉疾病、年龄较大和血红蛋白值较低。CA-AKI 是 DFU 患者 CTA 后常见的并发症。为了降低这些患者发生 CA-AKI 的风险,应考虑相关危险因素和预防措施。