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Contrast-induced nephropathy in patients undergoing endovascular peripheral vascular intervention: Incidence, risk factors, and outcomes as observed in the Blue Cross Blue Shield of Michigan Cardiovascular Consortium.
- Source :
-
Journal of interventional cardiology [J Interv Cardiol] 2017 Jun; Vol. 30 (3), pp. 274-280. Date of Electronic Publication: 2017 Apr 03. - Publication Year :
- 2017
-
Abstract
- Background: The incidence, risk factors, and outcomes associated with Contrast-induced nephropathy (CIN) after Percutaneous Vascular Intervention (PVI) in contemporary medical practice are largely unknown.<br />Methods: A total of 13 126 patients undergoing PVI were included in the analysis. CIN was defined as an increase in serum creatinine from pre-PVI baseline to post-PVI peak Cr of ≥0.5 mg/dL.<br />Results: CIN occurred in 3% (400 patients) of the cohort, and 26 patients (6.5%) required dialysis. Independent predictors of CIN were high and low body weight, diabetes, heart failure, anemia, baseline renal dysfunction, critical limb ischemia, and a higher acuity of the PVI procedure and a contrast dose that was greater than three times the calculated creatinine clearance (CCC) (adjusted OR 1.4, 95% CI: 1.1-1.8, P = 0.003). CIN was strongly associated with adverse outcome including in-hospital death (adjusted OR 18.1, CI 10.7-30.6, P < 0.001), myocardial infarction (adjusted OR 16.2, CI 8.9-29.5, P < 0.001), transient ischemic attack/stroke (adjusted OR 5.5, CI 3.2-14.9, P = 0.001), vascular access complications (adjusted OR 3.4, CI 2.3-5, P < 0.001), and transfusion (adjusted OR 7, CI 5.4-9, P < 0.001). Hospital stay was longer in patients who developed CIN versus those who did not.<br />Conclusions: CIN is not an uncommon complication associated with PVI, can be reliably predicted from pre-procedural variables, including a contrast dose of greater than three times the CCC and is strongly associated with the risk of in-hospital death, MI, stroke, transfusion, and increased hospital length of stay.<br /> (© 2017, Wiley Periodicals, Inc.)
- Subjects :
- Aged
Blue Cross Blue Shield Insurance Plans statistics & numerical data
Cohort Studies
Female
Humans
Incidence
Male
Michigan epidemiology
Middle Aged
Outcome and Process Assessment, Health Care
Prognosis
Quality Improvement
Risk Assessment
Risk Factors
Catheterization, Peripheral adverse effects
Catheterization, Peripheral methods
Catheterization, Peripheral statistics & numerical data
Contrast Media administration & dosage
Contrast Media adverse effects
Kidney Diseases chemically induced
Kidney Diseases epidemiology
Peripheral Arterial Disease diagnosis
Peripheral Arterial Disease surgery
Subjects
Details
- Language :
- English
- ISSN :
- 1540-8183
- Volume :
- 30
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- Journal of interventional cardiology
- Publication Type :
- Academic Journal
- Accession number :
- 28370487
- Full Text :
- https://doi.org/10.1111/joic.12379