J Korean Geriatr Soc.  2004 Mar;8(1):28-34.

Incidence, Risk factors, and Clinical Outcomes of Contrast Induced Nephropathy After Percutaneous Coronary Intervention in Elderly Patients

• Kim KI
• Bae J
• Kang HJ
• Chae IH
• Kim HS
• Sohn DW
• Kim CH
• Oh BH
• Lee MM
• Park YB
• Choi YS

Abstract

BACKGROUND: Contrast induced nephropathy(CIN) has been known to be a risk factor of significant in-hospital and long-term adverse outcomes. In old aged patients undergoing percutaneous coronary intervention(PCI) in the modern era, the incidence and prognostic implications of nephropathy are unknown.
METHODS
With a retrospective analysis of the clinical and angiographic data, we determined the incidence of, risk factors for, and prognostic implications of CIN(defined as an increase in serum creatinine[Cr] >0.5 mg/dL from baseline) after PCI.
RESULTS
Of 360 patients, 16(4.4%) patients experienced CIN and 5(1.4%) patients required temporary renal replacement therapy (hemodialysis or hemofiltration). Patients with baseline Cr 1.4 mg/dL and diabetic patients had a significant risk of CIN. In multivariate analysis, CIN was significantly associated with baseline renal dysfunction and diabetes showed marginal significance in developing CIN. Twenty-five percent of patients with CINdied during the index hospitalization compared with only 1.2% of patients without CIN (p<0.001). In patients with CIN, events of CIN impair renal function at six-month follow up.
CONCLUSIONS
In old aged patients who are undergoing PCI, diabetic patients with baseline renal impairment are at higher risk for CIN. Furthermore, CIN was highly correlated with death during the index hospitalization.

Keyword

Coronary disease; Acute renal failure; Angioplasty; Contrast dye

MeSH Terms

Acute Kidney Injury
Aged*
Angioplasty
Coronary Disease
Follow-Up Studies
Hospitalization
Humans
Incidence*
Multivariate Analysis
Percutaneous Coronary Intervention*
Renal Replacement Therapy
Retrospective Studies
Risk Factors*