Incidence of and Risk Factors for Contrast-Induced Nephropathy After Cardiac Catheterization in Japanese Patients

被引:30
|
作者
Abe, Mitsuru [1 ]
Kimura, Takeshi [2 ]
Morimoto, Takeshi [3 ]
Furukawa, Yutaka [4 ]
Kita, Toru [4 ]
机构
[1] Natl Cardiovasc Ctr, Div Cardiol, Suita, Osaka 5658565, Japan
[2] Kyoto Univ, Grad Sch Med, Dept Cardiovasc Med, Kyoto, Japan
[3] Kyoto Univ, Grad Sch Med, Ctr Med Educ, Kyoto, Japan
[4] Kobe City Med Ctr Gen Hosp, Dept Cardiovasc Med, Kobe, Hyogo, Japan
关键词
Cardiac catheterization; Contrast-induced nephropathy; Risk factors; PERCUTANEOUS CORONARY INTERVENTION; ACUTE-RENAL-FAILURE; SODIUM-BICARBONATE; PREVENTION; MEDIA; HEMODIALYSIS; ANGIOGRAPHY; HYDRATION; OUTCOMES; AGENT;
D O I
10.1253/circj.CJ-08-0784
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background: Contrast-induced nephropathy (CIN) is the third leading cause of all hospital-acquired renal insufficiency, accounting for 10%, and is associated with increased long-term mortality. The incidence of and risk factors for CIN after cardiac catheterization in Japanese patients are, however, unknown at present. Methods and Results: The 1, 157 consecutive patients who underwent cardiac catheterization at Kyoto University Hospital from January 2003 to December 2004 were retrospectively examined. The incidence of CIN defined as an absolute increase in serum creatinine (SCr) >= 0.5 mg/dl, a relative >= 25% increase in SCr, and either an absolute or relative increase after cardiac catheterization were 4.0%, 13.8%, and 13.9%, respectively. Multivariate logistic models revealed that preexisting renal insufficiency and the use of high-volume contrast were independently associated with an absolute increase in SCr >= 0.5 mg/dl. Female gender, underweight, and high-volume contrast usage were independently associated with a relative >= 25% increase and either an absolute or relative increase in SCr. Conclusions: Although the incidence of and risk factors for CIN after cardiac catheterization varied in the study population according to the definition of CIN, careful attention should be paid to patients who have risk factors identified by each definition of CIN. (Circ J 2009; 73: 1518-1522)
引用
收藏
页码:1518 / 1522
页数:5
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