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Risk Factors for Hemodialysis and Mortality in Patients With Contrast-Induced Nephropathy FREE TO VIEW

Hoang Lai, MD; Wilbert Aronow, MD; Savneek Chugh, MD; Basudev Pudasaini, MD; Arvind Goel, MD; Renee Garrick, MD
Chest. 2011;140(4_MeetingAbstracts):988A. doi:10.1378/chest.1119603
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Abstract

PURPOSE: This study was performed to identify risk factors for renal failure requiring hemodialysis and mortality in patients who developed contrast-induced nephropathy (CIN) after cardiac catheterization.

METHODS: Of 13,742 patients who had cardiac catheterization at Westchester Medical Center/New York Medical College during 2005-2008, 268 (2%) had a discharge diagnosis of renal failure, and 80 (1%) had CIN. CIN was defined as either a greater than 25% increase in serum creatinine or an absolute increase in serum creatinine of 0.5 mg/dL within 48 hours after cardiac catheterization. All 80 charts of patients with CIN were reviewed for baseline characteristics, medications, in-hospital complications, and mortality. The 80 patients with CIN included 46 men and 34 women, mean age 69 ± 14 years.

RESULTS: Of 80 patients with CIN, 18 (23%) died, and 22 (28%) developed renal failure requiring hemodialysis. Stepwise logistic regression analysis showed that significant independent risk factors for mortality were use of calcium channel blockers (odds ratio = 0.01; 95% CI, 0.0006-0.3544, p<0.01), catecholamine use (odds ratio = 91.74; 95% CI, 6.04-1392, p<0.01), and circulatory failure with lactic acidosis (odds ratio = 13.85; 95% CI,1.14-168, p <0.05). Significant independent risk factors for renal failure requiring hemodialysis were anemia (odds ratio = 11.32; 95% CI, 2.57-57.50, p <0.01), current smoking (odds ratio = 0.06; 95% CI, 0.0045-0.8080, p<0.05), N-acetylcysteine use (odds ratio = 0.08; 95% CI, 0.0148-0.4179, p <0.01), and circulatory failure with lactic acidosis (odds ratio = 9.76; 95% CI, 2.37-40, p <0.01).

CONCLUSIONS: Risk factors for mortality in patients with CIN were calcium channel blocker use (inverse association), catecholamine use, and circulatory failure with lactic acidosis. Risk factors for renal failure requiring hemodialysis were anemia, current smoking (inverse association), N-acetylcysteine use, and circulatory failure with lactic acidosis.

CLINICAL IMPLICATIONS: Risk factors for mortality in patients with CIN were calcium channel blocker use (inverse association), catecholamine use, and circulatory failure with lactic acidosis. Risk factors for renal failure requiring hemodialysis were anemia, current smoking (inverse association), N-acetylcysteine use, and circulatory failure with lactic acidosis

DISCLOSURE: The following authors have nothing to disclose: Hoang Lai, Wilbert Aronow, Savneek Chugh, Basudev Pudasaini, Arvind Goel, Renee Garrick

No Product/Research Disclosure Information

11:30 AM - 12:45 PM


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