Scholar: Irfanul Qayoom
Guide:
Reshi, Abdul Rashid; Najar, M. Saleem ; Banday, Khursheed A;
Bhat, M. Ashraf; Wani, Imtiyaz A.; Khan, Khursheed Aslam.
Title: Incidence of contrast induced nephropathy in coronary
angiography with or without percutaneous coronary intervention.
Keywords: Nephropathy-Non-azotemic Patients; Coronary
Angiography
Degree: M.D
Year:
2009
Institution: Dept of Nephrology and
Dept of Cardiology,
Sher-i-Kashmir Institute of Medical Sciences.
Abstract
Objectives: To study 1) the incidence of Contrast Induced Nephropathy in non-azotemic
patients undergoing Coronary Angiography with or without Percutaneous Coronary
Intervention (PCI). 2) Compare the incidence of Contrast Induced Nephropathy in high
risk patients undergoing Coronary Angiography vs low risk patients.
Study Design: Hospital based prospective study.
Materials & Methods: 150 patients undergoing Coronary Angiography with or without
PCI were selected randomly during 2006-2009; their renal function (Blood Urea, Serum
Creatinine & Creatinine Clearance) were evaluated and compared at baseline (0hrs), 24
hrs and 5 days after the procedure. Contrast Induced Nephropathy (CIN) defined as
increase in serum Creatinine of at least 25% or increase in 0.5mg/dl from baseline.
Results: Of 150, 73 were females and 77 were males; mean age of the patients was
54.60±11.60. The incidence of CIN was 8.7% at 24 hours and 2% at day 5 after the
procedure; CIN was commoner in diabetic patients (23%) than in non diabetic patients
(5.6%). Patients suffering from Left Ventricular dysfunction were at increased risk for
CIN particularly those patients who had Ejection Fraction less than 60%. The incidence
of CIN was 35.3% in hyperuricemic patients as compared to 5.50% patients with normal
Uric acid levels (<6mg/dl). In Patients with Contrast Induced Nephropathy Blood Urea at
24 hrs was 39.62±12.95 mg/dl and at 5 days was 40.40±15.10 mg/dl as compared to
mean baseline values (34.60±11.92). It was seen that there occurs significant change in
Blood urea as compared to Serum Creatinine and Creatinine Clearance in patients who
are suffering from CIN. On the other hand Serum Creatinine and Creatinine Clearance of
the patients who were suffering from CIN shows change both at 24 hours and 5 days
which was statistically insignificant.
Conclusions: The incidence of CIN is 8.7% at 24 hours and 2% at day 5 after the
procedure. The incidence of CIN in patients with various risk factors like Diabetes
Mellitus, CAD, Hyperuricemia, Hypertension is more as compared to patients with two
or less risk factors.