Proteinuria and Reduced Estimated Glomerular Filtration Rate Are Independent Risk Factors for Contrast-Induced Nephropathy After Cardiac Catheterization

• Saito Yoshihiko

  First Department of Internal Medicine, Nara Medical University

• Watanabe Makoto

  First Department of Internal Medicine, Nara Medical University

• Aonuma Kazutaka

  Cardiovascular Division, Faculty of Medicine, University of Tsukuba

• Hirayama Atsushi

  Division of Cardiology, Department of Medicine, Nihon University School of Medicine

• Tamaki Nagara

  Department of Nuclear Medicine, Hokkaido University Graduate School of Medicine

• Tsutsui Hiroyuki

  Department of Cardiovascular Medicine, Hokkaido University Graduate School of Medicine

• Murohara Toyoaki

  Department of Cardiology, Nagoya University Graduate School of Medicine

• Ogawa Hisao

  Department of Cardiovascular Medicine, Graduate School of Medical Science, Kumamoto University

• Akasaka Takashi

  Department of Cardiovascular Medicine, Wakayama Medical University

• Yoshimura Michihiro

  Division of Cardiology, Department of Internal Medicine, Jikei University School of Medicine

• Sato Akira

  Cardiovascular Division, Faculty of Medicine, University of Tsukuba

• Takayama Tadateru

  Division of Cardiology, Department of Medicine, Nihon University School of Medicine

• Sakakibara Mamoru

  Department of Cardiovascular Medicine, Hokkaido University Graduate School of Medicine

• Suzuki Susumu

  Department of Cardiology, Nagoya University Graduate School of Medicine

• Ishigami Kenichi

  Department of Cardiology, Saiseikai-Suita Hospital

• Onoue Kenji

  First Department of Internal Medicine, Nara Medical University

• on behalf of the CINC-J study investigators

• Hoshi Tomoya

• Hiraya Daigo

• Sakai Shunsuke

• Maruta Shunsuke

• Tsumagari Yasuaki

• Noguchi Yuichi

• Kakefuda Yuki

• Watabe Hiroaki

• Nakanishi Keita

• Otani Masafumi

• Kawabe Masayuki

• Hikita Hiroyuki

• Higuchi Yoshiharu

• Nishida Toshihiko

• Iida Korehito

• Uematsu Masaaki

• Ishihara Takayuki

• Kanda Takashi

• Ueda Yasunori

• Nishimoto Yuji

• Arima Ken

• Mano Hiroaki

• Oiwa Koji

• Matsumoto Michiaki

• Yahata Takaharu

• Mori Naoki

• Kato Hiroyasu

• Nishino Masami

• Tachibana Eizo

• Watanabe Yasuo

• Yahagi Takayuki

• Yajima Junji

• Murata Nobuhiro

• Kikushima Kimio

• Nagao Ken

• Nomoto Kazumiki

• Akutsu Naotaka

• Asakawa Naoya

• Inden Yasuya

• Hayashi Mutsuharu

• Ishii Hideki

• Yoshida Naoki

• Hirai Kaeko

• Iwama Hajime

• Kondo Hirokazu

• Nakagawa Yoshihisa

• Yamamoto Eiichirou

• Soejima Hirofumi

• Yamano Takashi

• Ino Yasushi

• Shiono Yasutsugu

• Yamaguchi Tomoyoshi

• Tamai Keiko

• Inoue Fumitaka

• Nakajima Tamio

• Sugimoto Hiroyuki

• Horii Manabu

• Yamamoto Yuuta

• Takemoto Yasuhiro

• Asoda Yasutaka

• Komeda Michitsugu

• Morimoto Takeshi

Abstract

Background:The aim of this study was to investigate the incidence of contrast-induced nephropathy (CIN) according to renal function in patients with or without proteinuria after cardiac catheterization in Japan.Methods and Results:We conducted a multicenter prospective observational study involving 27 hospitals from all over Japan, which enrolled 906 patients with cardiac catheterization. CIN was defined as increase in serum creatinine ≥0.5 mg/dl or ≥25% from baseline between 48 and 72 h after exposure to contrast. The incidence of CIN in patients with estimated glomerular filtration rate (eGFR) <30 ml/min/1.73 m²was significantly higher than that in patients with eGFR ≥60 ml/min/1.73 m². In patients without proteinuria, the incidence of CIN did not increase as eGFR decreased, but such a trend was observed in patients with proteinuria. Proteinuria was highly significantly associated with CIN in patients with eGFR 30–44 ml/min/1.73 m²(OR, 12.1; 95% CI: 2.81–82.8; P=0.0006) and eGFR <30 ml/min/1.73 m²(OR, 17.4; 95% CI: 3.32–321; P=0.0001). On multivariate logistic regression analysis, proteinuria (OR, 4.09; 95% CI: 1.66–10.0), eGFR (OR, 1.02; 95% CI: 1.00–1.04), contrast volume/eGFR (OR, 1.31; 95% CI: 1.04–1.65), and Ca antagonist use (OR, 3.79; 95% CI: 1.52–10.8) were significant predictors of CIN.Conclusions:Proteinuria and reduced eGFR are independent risk factors for CIN after cardiac catheterization. (Circ J 2015; 79: 1624–1630)

Journal

• Circulation Journal

  Circulation Journal 79 (7), 1624-1630, 2015

  The Japanese Circulation Society

Keywords

• Contrast-induced nephropathy
• Estimated glomerular filtration rate
• Proteinuria

Details

• CRID: 1390282680083638912
• NII Article ID: 130005083936
• NII Book ID: AA11591968
• DOI: 10.1253/circj.cj-14-1345
• ISSN: 13474820
• ISSN: 13469843
• NDL BIB ID: 026523808
• PubMed: 25891891
• Web Site: https://ndlsearch.ndl.go.jp/books/R000000004-I026523808
• Web Site: https://www.jstage.jst.go.jp/article/circj/79/7/79_CJ-14-1345/_pdf
• Web Site: https://search.jamas.or.jp/link/ui/2015335504
• Text Lang: en
• Data Source:
  • JaLC
  • NDL
  • Crossref
  • PubMed
  • CiNii Articles
• Abstract License Flag: Disallowed