# Incidence and risk factors for contrast-induced nephropathy after angioplasty: an observational retrospective study

## TL;DR

This study finds that 10.5% of angioplasty patients develop contrast-induced nephropathy, with diabetes, chronic kidney disease, and heart failure as key risk factors.

## Contribution

The study identifies diabetes mellitus as the main independent risk factor for contrast-induced nephropathy after angioplasty.

## Key findings

- Contrast-induced nephropathy occurred in 10.5% of patients.
- Diabetes mellitus was confirmed as the main independent risk factor (OR = 2.45).
- Chronic kidney disease and heart failure were also significant risk factors.

## Abstract

Contrast-induced nephropathy (CIN) is a complication of iodinated contrast media use that can lead to worsening of renal function, increased morbidity and mortality, and the need for renal replacement therapy.

To evaluate the incidence of CIN after angioplasty and identify associated factors, including variations in creatinine, glomerular filtration rate (GFR), contrast volume, procedure time, and comorbidities.

Retrospective study of 305 patients undergoing angioplasty. Clinical and laboratory variables, including serum creatinine and GFR before and after the procedure, were analyzed. CIN was defined as an absolute increase in creatinine ≥ 0.3 mg/dL or a relative increase ≥ 50% within 48 hours. Logistic regression was applied to identify independent predictors.

The incidence of CIN was 10.5% (n = 32/305). Patients with CIN showed a significant reduction in GFR (pre: 73.79 ± 22.5 vs. post: 34.32 ± 11.8 mL/min; p < 0.0001) and increased creatinine (pre: 1.12 ± 0.3 vs. post: 1.78 ± 0.6 mg/dL; p < 0.001). CIN was associated with stroke (p = 0.014), peripheral arterial occlusive disease (p = 0.007), diabetes mellitus (p = 0.002), chronic kidney disease (p = 0.005), and heart failure (p = 0.004). Multivariate analysis confirmed DM (OR = 2.45; 95% CI: 1.12–4.38; p = 0.022) as the main risk factor.

CIN occurred in 10.5% of patients, with DM, CKD, and HF being the main risk factors. These findings reinforce the importance of monitoring to reduce the impact of CIN and optimize clinical outcomes.

A nefropatia induzida por contraste (NIC) é uma complicação do uso de contraste iodado, podendo levar à piora da função renal, ao aumento da morbimortalidade e à necessidade de terapia renal substitutiva.

Avaliar a incidência de NIC após angioplastia e identificar fatores associados, incluindo variações na creatinina, na taxa de filtração glomerular, no volume de contraste, no tempo de procedimento e nas comorbidades.

Foi realizado um estudo retrospectivo com 305 pacientes submetidos à angioplastia. Foram analisadas variáveis clínicas e laboratoriais, incluindo creatinina sérica e taxa de filtração glomerular antes e após o procedimento. A NIC foi definida como o aumento absoluto da creatinina ≥ 0,5 mg/dL ou um aumento relativo ≥ 25% em até 72 horas. Aplicou-se regressão logística para identificar preditores independentes.

A incidência de NIC foi de 10,5% (n = 32). Pacientes com NIC apresentaram redução significativa da taxa de filtração glomerular (pré: 73,79 ± 22,5 mL/min versus pós: 34,32 ± 11,8 mL/min; p < 0,0001) e aumento da creatinina (pré: 1,12 ± 0,3 mL/min versus pós: 1,78 ± 0,6 mg/dL; p < 0,001). A NIC associou-se a acidente vascular encefálico (p = 0,014), doença arterial obstrutiva periférica (p = 0,007), diabetes melito (p = 0,002), doença renal crônica (p = 0,005) e insuficiência cardíaca (p = 0,004). A análise multivariada confirmou o diabetes melito (odds ratio = 2,45; IC95% 1,12-4,38; p = 0,022) como principal fator de risco.

A NIC ocorreu em 10,5% dos pacientes, sendo diabetes melito, insuficiência renal crônica e insuficiência cardíaca os principais fatores de risco. Esses achados reforçam a importância do monitoramento para reduzir o impacto da NIC e otimizar desfechos clínicos.