Metabolic Syndrome as a risk factor of Contrast Induced Nephropathy

AIM: Use of elevated amount of contrast agents has led contrast-induced nephropathy to a commonly encountered reason of acute renal failure. Contrast-induced nephropathy increases remerkably patient?s hospital stay, therapy costs, mortality and morbidity. Among the risk factors for CIN (Contrast- induced nephropathy) are preexisting renal insufficiency, diabetes, hypovolemy, older age, congestive heart failure, increased use of contrast media and use of nephrotoxic drugs. In literature, there are few studies carried out to determine whether metabolic syndrome is a risk factor for CIN, in which metabolic syndrome has been reported to be a risk factor (186). In our study, we investigated the relationship between metabolic syndrome along with underlying insulin resistance and contrast-induced nephropathy.MATERIAL AND METHOD: A total of 94 patients who had been admitted in Internal Clinics of Medical Faculty, Dicle University, and for some reason or another, whose CT were performed with contrast media, were included into the study. However, these patients were those with creatinin levels equal to or greater than 1.0. The patients? creatinin levels were checked before and 48 hours after performing CT , and those patients who developed CIN were determined. In addition, diabetes, hypertension, coronary artery disease, hyperlipidemy, stroke, heart failure, smoking habits were investigated, and the medication they received prior to performing CT and within the last 48 hours were recorded. All the patients were evaluated for metabolic syndrome by using IDF criteria; metabolic syndrome was determined in 39 patients. Fasting insulin and glucose values were controlled and HOMA-IR values were calculated in terms of insulin resistance.RESULTS: Into the study, 73 male and 21 female patients were included. In 10 of all the 94 patients, contrast-induced nephropathy developed. In 6 of these 10 patients, there was also metabolic syndrome. In other words, metabolic syndrome was detected in 60 % of the CIN group and in 38.1 % of those in the group in which CIN did not occur. Insulin resistance in both groups was seen to be 30 % and 17.9 % , respectively. The difference did not reach the statistical significance due to limited number of patients involved in the studThere was a significant difference between the two group for albumin, ürea, creatinin, uric acid, CRP, hemoglobin values. Also, between the groups, a marked differance was observed for basal creatinin clearancesIn CIN group , creatin clearances were lower and creatinine levels were higher. As reported in earlier studies, renal dysfunction was seen to be related to contrast-induced nephropathy.CONCLUSION: In recent years, CIN has started to be seen more commonly due to advances in imaging techniques. At present, there is not a specific treatment for CIN. Therefore, it is of utmost importance to recognize high-risk populations in advance and accordingly to take the necessary preventive measures. In recent years metabolic syndrome is blamed as a risk factor for CIN. Metabolic syndrome affects many people due to increased physical inactivity, central obesity and ageingIn conclusion in our study, although more patients with metabolic syndrome were detected in the group in which CIN developed, this difference did not reach the statistical significance. However, since the rate was high, more attention should be paid to CIN when contrast agents injected to patients with metabolic syndrome.Keywords: Contrast-İnduced Nephropathy, Metabolic Syndrome, Insulin Resistance