Perrotta Adolfo Marco, Gigante Antonietta, Rotondi Silverio, Menè Paolo, Notturni Adriano, Schiavetto Stefano, Tanzilli Gaetano, Pellicano Chiara, Guaglianone Giuseppe, Tinti Francesca, Palange Paolo, Mazzaferro Sandro, Cianci Rosario, Lai Silvia
Nephrology Unit, Department of Translational and Precision Medicine, Sapienza University of Rome, 00185 Rome, Italy.
Department of Translational and Precision Medicine, Sapienza University of Rome, 00185 Rome, Italy.
J Pers Med. 2023 Apr 21;13(4):701. doi: 10.3390/jpm13040701.
Contrast-induced acute kidney injury (CIAKI) is one of the main causes of acute renal failure in hospitalized patients, following the administration of iodinated contrast medium used for CT scans and angiographic procedures. CIAKI determines a high cardiovascular risk and appears to be one of the most feared complications of coronary angiography, causing a notable worsening of the prognosis with high morbidity and mortality.
To evaluate a possible association between the renal resistive index (RRI) and the development of CIAKI, as well as an association with the main subclinical markers of atherosclerosis and the main cardiovascular risk factors.
We enrolled 101 patients with an indication for coronary angiography. Patients underwent an assessment of renal function (serum nitrogen and basal creatinine, 48 and 72 h after administration of contrast medium), inflammation (C reactive protein (CRP), serum calcium and phosphorus, intact parathormone (iPTH), 25-hydroxyvitaminD (25-OH-VitD), serum uric acid (SUA), total cholesterol, serum triglycerides, serum glucose and insulin). All patients also carried out an evaluation of RRI, intima-media thickness (IMT), interventricular septum (IVS) and the ankle-brachial index (ABI).
101 patients (68 male), with a mean age of 73.0 ± 15.0 years, were enrolled for the study; 35 are affected by type 2 diabetes mellitus. A total of 19 cases of CIAKI were reported (19%), while among diabetic patients we reported an incidence of 23% (8 patients). In our study, patients with CIAKI had significantly higher RRI ( < 0.001) and IMT ( < 0.001) with respect to the patients who did not develop CIAKI. Furthermore, patients with CIAKI had significantly higher CRP ( < 0.001) and SUA ( < 0.006).
We showed a significant difference in RRI, IMT, SUA and CRP values between the population developing CIAKI and patients without CIAKI. This data appears relevant considering that RRI and IMT are low-cost, non-invasive and easily reproducible markers of endothelial dysfunction and atherosclerosis.
造影剂诱发的急性肾损伤（CIAKI）是住院患者急性肾衰竭的主要原因之一，发生于用于CT扫描和血管造影术的碘化造影剂给药之后。CIAKI会导致较高的心血管风险，似乎是冠状动脉造影最令人担忧的并发症之一，会使预后显著恶化，发病率和死亡率都很高。
评估肾阻力指数（RRI）与CIAKI发生之间的可能关联，以及与动脉粥样硬化主要亚临床标志物和主要心血管危险因素的关联。
我们纳入了101例有冠状动脉造影指征的患者。患者接受了肾功能评估（血清氮和基础肌酐，造影剂给药后48小时和72小时）、炎症指标评估（C反应蛋白（CRP）、血清钙和磷、全段甲状旁腺激素（iPTH）、25-羟基维生素D（25-OH-VitD）、血清尿酸（SUA）、总胆固醇、血清甘油三酯、血清葡萄糖和胰岛素）。所有患者还进行了RRI、内膜中层厚度（IMT）、室间隔（IVS）和踝臂指数（ABI）的评估。
101例患者（68例男性）纳入本研究，平均年龄73.0±15.0岁；35例患有2型糖尿病。共报告19例CIAKI（19%），而糖尿病患者中的发病率为23%（8例）。在我们的研究中，与未发生CIAKI的患者相比，发生CIAKI的患者RRI（<0.001）和IMT（<0.001）显著更高。此外，发生CIAKI的患者CRP（<0.001）和SUA（<0.006）显著更高。
我们发现发生CIAKI的人群与未发生CIAKI的患者在RRI、IMT、SUA和CRP值方面存在显著差异。考虑到RRI和IMT是低成本、非侵入性且易于重复的内皮功能障碍和动脉粥样硬化标志物，这一数据显得很重要。
