The risk indicators for high-level creatinine in patients with normal renal functions, following percutaneous coronary intervention

Contrast-induced nephropathy (CIN), is defined as acute reduction in kidney functions afterthe administration of contrast agent. The increasing usage of contrast agents, have made thecontrast-induced nephropathy as an increasingly encountered reason of acute renal failure.Contrast-induced nephropathy also increases the hospital stay, treatment cost, mortality andmorbidity of the patient significantly. Due to this reason, it is recommended to determine therisk factors of the patients and the applications of generally-accepted treatment regimes beforethe intervention, in order to prevent contrast-induced nephropathy.In our study, we aimed to research the ?risk indicators for high-level creatinine in patientswith normal renal functions, following percutaneous coronary intervention?Material-Methodology238 patients, who were subjected to PCI were taken to our study. The present single-centeredobservation study, was carried out retrospectively. The information of patients, whose preinterventionserum creatinine levels were below 1,2 mg/dl, and who were then subjected topercutaneous coronary intervention (PCI) were reached.The patients age, gender, accompanying diseases, nephrotoxic drugs they use, and theircontrast agent usage stories of the last 1 month were examined and recorded. Pre-interventionSodium (NA), serum Potassium (K), complete blood count, pre-intervention and post ?intervention serum BUN, creatinine (CRE), left ventricular ejection fraction (EF) according toechocardiography, and pre-intervention blood pressures of the patients were reached, alongwith their epicrisis information, and these were recorded. Patients included to the study weredivided into two groups, according to their creatinine values as of the 24th hour following theintervention (Group I: Patients with post-PCI CRE<1.2 mg/dl; Group II: Patients with post-PCI CRE ?1.2 mg/dl). Afterwards, these two groups were further examined withinthemselves, according to risk factors.100-300 ml low osmolar non-ionic monomer iopromide (ultravist vial, 370-200 ml vial) wasapplied to the patients during intravenous PCI.XIIBefore the intervention, all patients were applied with 500 ml 0,9% NACL liquid in total(100-120 ml/hour). After the intervention, they were applied 1000 ml 0,9% NACL liquid intotal (100-120 ml/hour).Comparison was made between these two groups in terms of contrast-induced nephropathy.Regression analysis was made, and dependent and independent risk factors (indicators)causing contrast-induced nephropathy were determined.ResultsIn the study we made, the size of Group I and Group II were determined respectively as18,5% (n=44) and 81,5% (n=194). When these groups were compared in terms of risk factors,heart failure (25% n=11) and male gender (77,3%, n=34) were determined as independent riskfactors in the development of contrast-induced nephropathy (respectively, p<0,035 andp<0,006). Also, in the correlation analysis carried out, it was determined that the patientswhose CRE values increase significantly during their follow-ups, also have their heart failuredegrees increased significantly, in the same correlation.ConclusionIn all interventions made through using contrast agent, CIN risk factors shall be taken intoaccount, and special care shall be taken in high-risk patients whose gender is male and/or whohave heart failure. CIKeywords: Percutaneous coronary intervention (PCI), Heart Failure, Contrast-inducednephropathy (CIN)