The contrast induced nephropathy is a cause of acute renal failure with the waning of angiographic procedures. This complication is a growing concern because of its impact on morbidity and mortality of patients, especially in cardiac patients undergoing coronary angiography. This is a particular population where renal function is often decreased see altered upon exposure to contrast medium. The aim of this study was to determine the incidence of contrast-induced nephropathy in patients with a coronary angiography procedure and assess their predictors.
We identified all patients admitted to the cardiology department for an angiography procedure between January 2014 and December 2019. We included 746 patients who passed by catheterization lab and undergoing fluid injection diagnostic or therapeutic target in contrast under urgent situations or deferred, including 738 patients for whom we had a complete set of measurements of serum creatinine and we performed a univariate analysis identified factors.
The incidence of contrast-induced nephropathy in our population is 16.4%. Our univariate analysis identified several risk factors such as GFR <60ml/min/1.73m2 P=0.005, LV systolic dysfunction LVEF <35% P=0.006; hypotension (P=0.005), the preparation of the patient (P=0.017), amount of PC (P=0.0001), IEC socket/ARA II (P=0.046).
Our results suggest that renal failure at admission and LV systolic dysfunction, low blood pressure at the time of injection of PC, the IEC socket are predictors.
These results contrast with data from published literature, which can be explained in part by changes in our practices, but also by epidemiological characteristics specific to our population and the size of our cohort. However, they argue for consideration of the increased risk of contrast-induced nephropathy in patients at risk, including providing a more prolonged monitoring of renal function in post-angiography.Le texte complet de cet article est disponible en PDF.