Risk factors of contrast-induced nephropathy in the elderly patients with diabetes
10.3760/cma.j.issn.0254-9026.2012.08.006
- VernacularTitle:老年糖尿病患者造影剂肾病的危险因素分析
- Author:
Zhan LI
;
Hua WU
;
Qing HE
- Publication Type:Journal Article
- Keywords:
Nephrosis;
Diabetes mellitus,type 2;
Risk factors;
Coronary angiography
- From:
Chinese Journal of Geriatrics
2012;31(8):662-665
- CountryChina
- Language:Chinese
-
Abstract:
Objective To understand the clinical feature of the elderly patients with diabetes during coronary angiography,and analyze the risk factors of contrast-induced nephropathy (CIN).Methods The clinical data of 269 elderly patients who had undergone coronary angiography and percutaneous coronary intervention(PCI) from January 2007 to December 2009 in our hospital were analyzed retrospectively.The patients were divided into two groups:CIN group and non-CIN group.The possible risk factors for CIN,such as glycemic control,diabetic complication,renal function,volume of contrast medium,inflammatory state,therapy of perioperative period,past medical history were analyzed and compared between the two groups. Results In 269 elderly patients with diabetes,the incidence of CIN was 9.3 % (25/269).According to estimated glomerular filtration rate (e-GFR),the patients were divided into four subgroup:≥90 ml/min,89-60 ml/min,59-30 ml/min,<29 ml/min.The incidences of CIN for the subgroups were 2.2%(1/45),4.4%(6/135),17.3%(14/81) and 50 % (4/8),respectively.Multivariate logistic gradual regressive analysis showed that loop diuretic use (OR> 6.07),preoperative e-GFR(<60 ml/min) (OR>3.27),volume of contrast medium (≥200ml) (OR>3.26),chronic kidney disease(CKD) (OR>2.80) (P=0.001,0.024,0.015,0.048) were indepen-dent risk factors for CIN (P<0.05). Conclusions Loop diuretic use,preoperative GFR (<60 ml/min),volume of contrast medium (≥200 ml) and CKD are independent risk factors of CIN.