Usta Akin, Usta Ceyda Sancakli, Lafci Duygu, Kiris Tuncay, Avci Eyup
Department of Obstetrics and Gynecology, School of Medicine, Balikesir University, Cagis Campusu, Altieylul, Altıeylül/Balikesir, 10145, Turkey.
Department of Cardiology, School of Medicine, Izmir Katip Celebi University, Izmir, Turkey.
Reprod Biol Endocrinol. 2024 Dec 19;22(1):156. doi: 10.1186/s12958-024-01334-3.
Contrast-induced nephropathy (CIN) defined as an acute kidney injury following the administration of iodinated contrast medium (CM). Hysterosalpingography (HSG) is a radiologic procedure used to investigate the shape and structure of the uterine cavity and the patency of the fallopian tubes in the evaluation of infertility. To date, there have been no reports evaluating the development of CIN after HSG procedure. Therefore, we investigated whether CIN development occurs in infertile women who underwent HSG and its relationship with clinical and laboratory changes in women who underwent HSG.
This study was undertaken in 65 women who had infertility evaluation, uterine anomalies and/or tubal blockages. CIN was defined as a 25% relative increase, or a 0.5 mg/dL (44 µmol/L) absolute increase, in serum baseline creatinine (SCr) within 72 h of contrast exposure in the absence of alternative conditions. Hysterosalpingography (HSG) was performed using 5-20 ml of contrast medium. All patients performed routine laboratory tests including assessment of serum creatinine and urea and estimated glomerular filtration rates before and 2-3 day after HSG. Statistical analysis was performed with MedCalc Statistical Software Program v22.023 (Ostend, Belgium) program.
The mean ages of participants were 29.5 years and mean BMI were 26.2 kg/m2. The rate of CIN was 12.3% and the severe nephropathy was 1.5% in our study population. The baseline SCr level was 0.59 ± 0.06 mg/dL in women with CIN and 0.67 ± 0.11 mg/dL in women without CIN. The baseline SCr level was significantly lower in CIN group that non-CIN group (p = 0.0309). The SCr level significantly higher in CIN group than non-CIN group 48-72 h after HSG (p = 0.0005). In the multivariate logistic regression analysis, the baseline SCr was found an independent risk factor for the prediction of CIN in women who underwent HSG.
The HSG procedure is generally a safe method, but the iodine-containing contrast material used in HSG may be associated with temporary adverse effects on kidney function.
对比剂肾病（CIN）定义为在使用碘化造影剂（CM）后发生的急性肾损伤。子宫输卵管造影（HSG）是一种放射学检查方法，用于在评估不孕症时研究子宫腔的形态和结构以及输卵管的通畅性。迄今为止，尚无关于HSG术后CIN发生情况的报道。因此，我们调查了接受HSG的不孕女性是否会发生CIN，以及其与接受HSG的女性临床和实验室变化的关系。
本研究纳入了65名进行不孕症评估、存在子宫异常和/或输卵管阻塞的女性。CIN定义为在造影剂暴露后72小时内，血清基线肌酐（SCr）相对升高25%，或绝对升高0.5mg/dL（44µmol/L），且不存在其他替代情况。使用5 - 20ml造影剂进行子宫输卵管造影（HSG）。所有患者在HSG前及HSG后2 - 3天进行常规实验室检查，包括血清肌酐、尿素评估及估算肾小球滤过率。使用MedCalc统计软件程序v22.023（比利时奥斯坦德）进行统计分析。
参与者的平均年龄为29.5岁，平均体重指数为26.2kg/m²。在我们的研究人群中，CIN发生率为12.3%，严重肾病发生率为1.5%。发生CIN的女性基线SCr水平为0.59±0.06mg/dL，未发生CIN的女性为0.67±0.11mg/dL。CIN组的基线SCr水平显著低于非CIN组（p = 0.0309）。HSG后48 - 72小时，CIN组的SCr水平显著高于非CIN组（p = 0.0005）。在多因素逻辑回归分析中，发现基线SCr是预测接受HSG女性发生CIN的独立危险因素。
HSG检查通常是一种安全的方法，但HSG中使用的含碘造影剂可能会对肾功能产生暂时的不良影响。
