Novel risk score of contrast-induced nephropathy after percutaneous coronary intervention

Nephrology (Carlton). 2015 Aug;20(8):544-51. doi: 10.1111/nep.12429.

Abstract

Aim: Contrast-induced nephropathy (CIN) post-percutaneous coronary intervention (PCI) is a major cause of acute kidney injury. In this study, we established a comprehensive risk score model to assess risk of CIN after PCI procedure, which could be easily used in a clinical environment.

Methods: A total of 805 PCI patients, divided into analysis cohort (70%) and validation cohort (30%), were enrolled retrospectively in this study. Risk factors for CIN were identified using univariate analysis and multivariate logistic regression in the analysis cohort. Risk score model was developed based on multiple regression coefficients. Sensitivity and specificity of the new risk score system was validated in the validation cohort. Comparisons between the new risk score model and previous reported models were applied.

Results: The incidence of post-PCI CIN in the analysis cohort (n = 565) was 12%. Considerably high CIN incidence (50%) was observed in patients with chronic kidney disease (CKD). Age >75, body mass index (BMI) >25, myoglobin level, cardiac function level, hypoalbuminaemia, history of chronic kidney disease (CKD), Intra-aortic balloon pump (IABP) and peripheral vascular disease (PVD) were identified as independent risk factors of post-PCI CIN. A novel risk score model was established using multivariate regression coefficients, which showed highest sensitivity and specificity (0.917, 95%CI 0.877-0.957) compared with previous models.

Conclusion: A new post-PCI CIN risk score model was developed based on a retrospective study of 805 patients. Application of this model might be helpful to predict CIN in patients undergoing PCI procedure.

Keywords: contrast-induced nephropathy; percutaneous coronary intervention; risk score.

Publication types

  • Validation Study

MeSH terms

  • Acute Kidney Injury / chemically induced*
  • Acute Kidney Injury / diagnosis
  • Acute Kidney Injury / epidemiology
  • Age Factors
  • Aged
  • Aged, 80 and over
  • China / epidemiology
  • Comorbidity
  • Contrast Media / adverse effects*
  • Decision Support Techniques*
  • Female
  • Humans
  • Incidence
  • Intra-Aortic Balloon Pumping / adverse effects
  • Logistic Models
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Percutaneous Coronary Intervention / adverse effects*
  • Predictive Value of Tests
  • Reproducibility of Results
  • Retrospective Studies
  • Risk Assessment
  • Risk Factors

Substances

  • Contrast Media