Рrevention of contrast-induced nephropathy during interventional treatment of acute coronary syndrome
The aim of the work was to determine the risk factors of contrast-induced nephropathy in patients with acute coronary syndrome and to evaluate the effectiveness of methods of its prevention. There were examined 62 patients admitted to the interventional cardiology department during 9 months of routi...
Saved in:
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Dnipro State Medical University
2023-12-01
|
| Series: | Medičnì Perspektivi |
| Subjects: | |
| Online Access: | https://journals.uran.ua/index.php/2307-0404/article/view/294013 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1841563044712284160 |
|---|---|
| author | L.O. Miakinkova T.I. Yarmola G.L. Pustovoit Iu.A. Kostrikova B.O. Pysana V.V. Talash |
| author_facet | L.O. Miakinkova T.I. Yarmola G.L. Pustovoit Iu.A. Kostrikova B.O. Pysana V.V. Talash |
| author_sort | L.O. Miakinkova |
| collection | DOAJ |
| description | The aim of the work was to determine the risk factors of contrast-induced nephropathy in patients with acute coronary syndrome and to evaluate the effectiveness of methods of its prevention. There were examined 62 patients admitted to the interventional cardiology department during 9 months of routine practice with a diagnosis of acute coronary syndrome and concomitant chronic kidney disease. Among them, 56.45% have diabetic nephropathy, 21% – hypertensive nephropathy, 19.35% – chronic pyelonephritis, 3.2% – gouty nephropathy. According to the stages of chronic kidney disease: I stage – 8.1%, II stage – 46.8%, III A stage – 30.6%, III B stage – 14.5% of patients. The control group consisted of 32 patients with acute coronary syndrome without kidney pathology. All patients underwent urgent percutaneous coronary intervention with a water-soluble low-osmolarity radiocontrast medium. The risk of contrast-induced nephropathy was determined according to the Mehran scale. Contrast-induced nephropathy was diagnosed by an increase in serum creatinine by >25% over 24-48 hours. Prevention of contrast-induced nephropathy according to existing recommendations was carried out by prescribing early statin therapy and diuresis-controlled combined hydration in 22 patients with concomitant chronic kidney disease. Mathematical processing was performed using Statistica 8.0 software (StatSoft Inc, USA). Patients with chronic kidney disease had a high and very high risk of contrast-induced nephropathy in 19.4% and 3.2% of cases, among them in 91.6% high, and in 100% – very high-risk contrast-induced nephropathy developed. Patients in the control group had a low to moderate risk, none of them developed contrast-induced nephropathy. It has been shown that the risk of contrast-induced nephropathy depends on the stage of chronic kidney disease and is associated with a decrease in the ejection fraction of the left ventricle (≤40%), acute left ventricle failure of the III and IV classes according to Killip, a decrease in diuresis up to ≤0.6 ml/h/kg in the first 12-24 hours after urgent percutaneous coronary intervention; taking metformin 6-12 hours before the administration of the X-ray contrast medium and the glomerular filtration rate ≤45 ml/min./1.73 m2. In patients who underwent prevention of contrast-induced nephropathy in its entirety, its development was not registered. |
| format | Article |
| id | doaj-art-1a38db1241644ec0aa3dc8970e6a33a5 |
| institution | Kabale University |
| issn | 2307-0404 |
| language | English |
| publishDate | 2023-12-01 |
| publisher | Dnipro State Medical University |
| record_format | Article |
| series | Medičnì Perspektivi |
| spelling | doaj-art-1a38db1241644ec0aa3dc8970e6a33a52025-01-03T00:18:54ZengDnipro State Medical UniversityMedičnì Perspektivi2307-04042023-12-01284495710.26641/2307-0404.2023.4.294013332313Рrevention of contrast-induced nephropathy during interventional treatment of acute coronary syndromeL.O. Miakinkova0https://orcid.org/0000-0002-3889-3735T.I. Yarmola1https://orcid.org/0000-0002-7428-0223G.L. Pustovoit2https://orcid.org/0000-0001-6879-8088Iu.A. Kostrikova3https://orcid.org/0000-0002-8675-8896B.O. Pysana4https://orcid.org/0000-0002-7021-6697V.V. Talash5Poltava State Medical UniversityPoltava State Medical University, Shevchenko str. 23, Poltava, 36000Poltava State Medical University, Shevchenko str. 23, Poltava, 36000Poltava State Medical University, Shevchenko str. 23, Poltava, 36000Poltava State Medical University, Shevchenko str. 23, Poltava, 36000Poltava state medical university, Shevchenko str., 23, Poltava, 36011The aim of the work was to determine the risk factors of contrast-induced nephropathy in patients with acute coronary syndrome and to evaluate the effectiveness of methods of its prevention. There were examined 62 patients admitted to the interventional cardiology department during 9 months of routine practice with a diagnosis of acute coronary syndrome and concomitant chronic kidney disease. Among them, 56.45% have diabetic nephropathy, 21% – hypertensive nephropathy, 19.35% – chronic pyelonephritis, 3.2% – gouty nephropathy. According to the stages of chronic kidney disease: I stage – 8.1%, II stage – 46.8%, III A stage – 30.6%, III B stage – 14.5% of patients. The control group consisted of 32 patients with acute coronary syndrome without kidney pathology. All patients underwent urgent percutaneous coronary intervention with a water-soluble low-osmolarity radiocontrast medium. The risk of contrast-induced nephropathy was determined according to the Mehran scale. Contrast-induced nephropathy was diagnosed by an increase in serum creatinine by >25% over 24-48 hours. Prevention of contrast-induced nephropathy according to existing recommendations was carried out by prescribing early statin therapy and diuresis-controlled combined hydration in 22 patients with concomitant chronic kidney disease. Mathematical processing was performed using Statistica 8.0 software (StatSoft Inc, USA). Patients with chronic kidney disease had a high and very high risk of contrast-induced nephropathy in 19.4% and 3.2% of cases, among them in 91.6% high, and in 100% – very high-risk contrast-induced nephropathy developed. Patients in the control group had a low to moderate risk, none of them developed contrast-induced nephropathy. It has been shown that the risk of contrast-induced nephropathy depends on the stage of chronic kidney disease and is associated with a decrease in the ejection fraction of the left ventricle (≤40%), acute left ventricle failure of the III and IV classes according to Killip, a decrease in diuresis up to ≤0.6 ml/h/kg in the first 12-24 hours after urgent percutaneous coronary intervention; taking metformin 6-12 hours before the administration of the X-ray contrast medium and the glomerular filtration rate ≤45 ml/min./1.73 m2. In patients who underwent prevention of contrast-induced nephropathy in its entirety, its development was not registered.https://journals.uran.ua/index.php/2307-0404/article/view/294013contrast-induced nephropathyurgent percutaneous coronary interventionacute coronary syndromechronic kidney disease |
| spellingShingle | L.O. Miakinkova T.I. Yarmola G.L. Pustovoit Iu.A. Kostrikova B.O. Pysana V.V. Talash Рrevention of contrast-induced nephropathy during interventional treatment of acute coronary syndrome Medičnì Perspektivi contrast-induced nephropathy urgent percutaneous coronary intervention acute coronary syndrome chronic kidney disease |
| title | Рrevention of contrast-induced nephropathy during interventional treatment of acute coronary syndrome |
| title_full | Рrevention of contrast-induced nephropathy during interventional treatment of acute coronary syndrome |
| title_fullStr | Рrevention of contrast-induced nephropathy during interventional treatment of acute coronary syndrome |
| title_full_unstemmed | Рrevention of contrast-induced nephropathy during interventional treatment of acute coronary syndrome |
| title_short | Рrevention of contrast-induced nephropathy during interventional treatment of acute coronary syndrome |
| title_sort | рrevention of contrast induced nephropathy during interventional treatment of acute coronary syndrome |
| topic | contrast-induced nephropathy urgent percutaneous coronary intervention acute coronary syndrome chronic kidney disease |
| url | https://journals.uran.ua/index.php/2307-0404/article/view/294013 |
| work_keys_str_mv | AT lomiakinkova rreventionofcontrastinducednephropathyduringinterventionaltreatmentofacutecoronarysyndrome AT tiyarmola rreventionofcontrastinducednephropathyduringinterventionaltreatmentofacutecoronarysyndrome AT glpustovoit rreventionofcontrastinducednephropathyduringinterventionaltreatmentofacutecoronarysyndrome AT iuakostrikova rreventionofcontrastinducednephropathyduringinterventionaltreatmentofacutecoronarysyndrome AT bopysana rreventionofcontrastinducednephropathyduringinterventionaltreatmentofacutecoronarysyndrome AT vvtalash rreventionofcontrastinducednephropathyduringinterventionaltreatmentofacutecoronarysyndrome |