Contrast induced nephropathy risk factors: Difference between revisions
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(Created page with "__NOTOC__ {{Contrast induced nephropathy}} {{CMG}} ==Overview== ==Risk Factors== ===Predictors of Contrast-Induced Nephropathy=== *Three factors have been associated with an...") |
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==Overview== | ==Overview== | ||
Three factors have been associated with an increased risk of contrast-induced nephropathy: ''pre-existing [[renal insufficiency]]'' (such as [[Creatinine clearance]] < 60 mL/min [1.00 mL/s] - [http://www.intmed.mcw.edu/clincalc/creatinine.html online calculator]), ''pre-existing [[diabetes]]'', and ''reduced intravascular volume''.<ref name="pmid9375704">{{cite journal | author=McCullough PA, Wolyn R, Rocher LL, Levin RN, O'Neill WW | title=Acute renal failure after coronary intervention: incidence, risk factors, and relationship to mortality | journal=Am J Med | year=1997 | pages=368-75 | volume=103 | issue=5 | id=PMID 9375704}}</ref><ref name="pmid10334456">{{cite journal | author=Scanlon PJ, Faxon DP, Audet AM, Carabello B, Dehmer GJ, Eagle KA, Legako RD, Leon DF, Murray JA, Nissen SE, Pepine CJ, Watson RM, Ritchie JL, Gibbons RJ, Cheitlin MD, Gardner TJ, Garson A Jr, Russell RO Jr, Ryan TJ, Smith SC Jr | title=ACC/AHA guidelines for coronary angiography. A report of the American College of Cardiology/American Heart Association Task Force on practice guidelines (Committee on Coronary Angiography). Developed in collaboration with the Society for Cardiac Angiography and Interventions | journal=J Am Coll Cardiol | year=1999 | pages=1756-824 | volume=33 | issue=6 | id=PMID 10334456}}</ref> A '''[[clinical prediction rule]]''' is available to estimate probability of nephropathy (increase ≥25% and/or ≥0.5 mg/dl in serum creatinine at 48 h)<ref name="pmid15464318">{{cite journal |author=Mehran R, Aymong ED, Nikolsky E, ''et al'' |title=A simple risk score for prediction of contrast-induced nephropathy after percutaneous coronary intervention: development and initial validation |journal=J. Am. Coll. Cardiol. |volume=44 |issue=7 |pages=1393–9 |year=2004 |pmid=15464318 |doi=10.1016/j.jacc.2004.06.068}}</ref>: | |||
====Risk Factors:==== | ====Risk Factors:==== | ||
* [[Systolic blood pressure]] <80 mm Hg - 5 points | * [[Systolic blood pressure]] <80 mm Hg - 5 points | ||
Revision as of 21:55, 15 December 2012
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Three factors have been associated with an increased risk of contrast-induced nephropathy: pre-existing renal insufficiency (such as Creatinine clearance < 60 mL/min [1.00 mL/s] - online calculator), pre-existing diabetes, and reduced intravascular volume.[1][2] A clinical prediction rule is available to estimate probability of nephropathy (increase ≥25% and/or ≥0.5 mg/dl in serum creatinine at 48 h)[3]:
Risk Factors:
- Systolic blood pressure <80 mm Hg - 5 points
- Intraarterial balloon pump - 5 points
- Congestive heart failure (Class III-IV or history of pulmonary edema) - 5 points
- Age >75 y - 4 points
- Hematocrit level <39% for men and <35% for women - 3 points
- Diabetes - 3 points
- Contrast media volume - 1 point for each 100 mL
- Renal insufficiency:
- Serum creatinine level >1.5 g/dL - 4 points OR
- Estimated Glomerular filtration rate (online calculator)
- 2 for 40–60 mL/min/1.73 m2
- 4 for 20–40 mL/min/1.73 m2
- 6 for < 20 mL/min/1.73 m2
Scoring:
5 or less points
- Risk of CIN - 7.5
- Risk of Dialysis - 0.04%
6–10 points
- Risk of CIN - 14.0
- Risk of Dialysis - 0.12%
11–16 points
- Risk of CIN - 26.1*
- Risk of Dialysis - 1.09%
>16 points
- Risk of CIN - 57.3
- Risk of Dialysis - 12.8%
References
- ↑ McCullough PA, Wolyn R, Rocher LL, Levin RN, O'Neill WW (1997). "Acute renal failure after coronary intervention: incidence, risk factors, and relationship to mortality". Am J Med. 103 (5): 368–75. PMID 9375704.
- ↑ Scanlon PJ, Faxon DP, Audet AM, Carabello B, Dehmer GJ, Eagle KA, Legako RD, Leon DF, Murray JA, Nissen SE, Pepine CJ, Watson RM, Ritchie JL, Gibbons RJ, Cheitlin MD, Gardner TJ, Garson A Jr, Russell RO Jr, Ryan TJ, Smith SC Jr (1999). "ACC/AHA guidelines for coronary angiography. A report of the American College of Cardiology/American Heart Association Task Force on practice guidelines (Committee on Coronary Angiography). Developed in collaboration with the Society for Cardiac Angiography and Interventions". J Am Coll Cardiol. 33 (6): 1756–824. PMID 10334456.
- ↑ Mehran R, Aymong ED, Nikolsky E; et al. (2004). "A simple risk score for prediction of contrast-induced nephropathy after percutaneous coronary intervention: development and initial validation". J. Am. Coll. Cardiol. 44 (7): 1393–9. doi:10.1016/j.jacc.2004.06.068. PMID 15464318.