Contrast Induced Nephropathy and its predictors after Primary Percutaneous Intervention

Authors

  • Krishna Chandra Adhikari National Academy of Medical Sciences, Bir Hospital, Kathmandu, Nepal https://orcid.org/0000-0001-9781-1405
  • Rabi Malla Shahid Gangalal National Heart Centre, Kathmandu, Nepal
  • Arun Maskey Shahid Gangalal National Heart Centre, Kathmandu, Nepal
  • Sujeeb Rajbhandari Shahid Gangalal National Heart Centre, Kathmandu, Nepal
  • Bishow Raj Baral National Academy of Medical Sciences, Bir Hospital, Kathmandu, Nepal
  • Arjun Budhathoki National Academy of Medical Sciences, Bir Hospital, Kathmandu, Nepal
  • Shreya Bhandari Shahid Gangalal National Heart Centre, Kathmandu, Nepal
  • Shipra Shrestha Shahid Gangalal National Heart Centre, Kathmandu, Nepal
  • Rabindra Simkhada Shahid Gangalal National Heart Centre, Kathmandu, Nepal
  • Parag Karki Army Institute of Health Sciences, Shree Birendra Hospital, Nepal

DOI:

https://doi.org/10.3126/njh.v18i2.40401

Keywords:

Contrast Media, Contrast Induced Nephropathy, Primary Percutaneous Coronary Intervention

Abstract

Background and Aims: Worldwide many patients are receiving intravascular contrast media (CM) during interventional procedures. Contrast media are used to enhance visualization and guide percutaneous coronary interventions (PCI).1 However, the use of CM also carries the risk of complications and it is important to be aware of these complications. Complications with CM range from mild symptoms to life-threatening conditions like anaphylaxis, hypotension and renal dysfunction and contrast-induced nephropathy (CIN) is one of them which can have both short and long term consequences.2 This study aimed to know the incidence of CIN in our center and possible predictors associated with it.

Methods: This is the single hospital based cross sectional observational study. Patients undergoing primary PCI were enrolled in the study. All the patients underwent thorough history taking and physical examination. Baseline required laboratory investigations were sent. Electrocardiogram and echocardiography screening was done before taking patient to primary PCI as per the protocol of the hospital.

Results: The number of patients enrolled in the study was 83 out of which 65(78.2%) were males and mean age was 59.7±13.2. Mean Arterial Pressure (MAP) among the patients was 103.8±21.3. Almost 2/3rd of the population received intravenous fluids. Minimum contrast volume used was 50ml and maximum was 270. When absolute rise in creatinine was considered 12 (14.5%) had CIN and when percent rise was also considered total 28 (33.7%) had CIN. While evaluating the predictors of CIN, higher mean age (p=0.01), hypotension with mean MAP <60 mmhg (p=0.04)) and higher contrast volume >100ml (p=0.04) was found to be significant.

Conclusion: The incidence of CIN in patients undergoing PPCI was similar to the studies done in other parts of the world. Evaluating the predictors of CIN, higher mean age, hypotension and higher contrast volume was the significant predictor.

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Author Biographies

Krishna Chandra Adhikari, National Academy of Medical Sciences, Bir Hospital, Kathmandu, Nepal

Department of Cardiology

Rabi Malla, Shahid Gangalal National Heart Centre, Kathmandu, Nepal

Department of Cardiology

Arun Maskey, Shahid Gangalal National Heart Centre, Kathmandu, Nepal

Department of Cardiology

Sujeeb Rajbhandari, Shahid Gangalal National Heart Centre, Kathmandu, Nepal

Department of Cardiology

Bishow Raj Baral, National Academy of Medical Sciences, Bir Hospital, Kathmandu, Nepal

Department of Cardiology

Arjun Budhathoki, National Academy of Medical Sciences, Bir Hospital, Kathmandu, Nepal

Department of Cardiology

Shreya Bhandari, Shahid Gangalal National Heart Centre, Kathmandu, Nepal

Department of Cardiology

Shipra Shrestha, Shahid Gangalal National Heart Centre, Kathmandu, Nepal

Department of Cardiology

Rabindra Simkhada, Shahid Gangalal National Heart Centre, Kathmandu, Nepal

Department of Cardiology

Parag Karki, Army Institute of Health Sciences, Shree Birendra Hospital, Nepal

Department of Medicine

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Published

2021-11-23

How to Cite

Adhikari, K. C., Malla, R., Maskey, A., Rajbhandari, S., Baral, B. R., Budhathoki, A., Bhandari, S., Shrestha, S., Simkhada, R., & Karki, P. (2021). Contrast Induced Nephropathy and its predictors after Primary Percutaneous Intervention . Nepalese Heart Journal, 18(2), 27–31. https://doi.org/10.3126/njh.v18i2.40401

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Section

Original Articles