The Estimated Glomerular Filtration Rate With Using the Mayo Clinic Quadratic Equation as a New Predictor for Developing Contrast Induced Nephropathy in Patients With Angina Pectoris.
10.4070/kcj.2008.38.6.301
- Author:
Ung KIM
1
;
Young Jo KIM
;
Won Jae LEE
;
Sang Hee LEE
;
Geu Ru HONG
;
Jong Seon PARK
;
Dong Gu SHIN
;
Bong Sup SHIM
Author Information
1. Cardiology Division, Department of Internal Medicine, Yeungnam University Medical Center, Daegu, Korea. yjkim@med.yu.ac.kr
- Publication Type:Original Article
- Keywords:
Glomerular filtration rate;
Contrast media;
Coronary angiography
- MeSH:
Angina Pectoris;
Angina, Unstable;
Angiography;
C-Reactive Protein;
Cholesterol;
Cholesterol, LDL;
Contrast Media;
Coronary Angiography;
Creatinine;
Glomerular Filtration Rate;
Humans;
Kidney Diseases;
Lipoproteins;
Multivariate Analysis;
Percutaneous Coronary Intervention;
Risk Factors;
Stroke Volume
- From:Korean Circulation Journal
2008;38(6):301-304
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND AND OBJECTIVES: The Mayo clinic quadratic (MCQ) glomerular filtration rate (GFR) equation accurately estimates the GFR when the presence of kidney disease is unknown. The aim of this study is to evaluate the usefulness of the MCQ GFR equation for predicting contrast-induced nephropathy (CIN) in patients with angina pectoris and who are undergoing coronary angiography (CAG) or percutaneous coronary intervention (PCI). SUBJECTS AND METHODS: One hundred seven patients diagnosed with stable or unstable angina and who had normal serum creatinine levels (SCr <1.5 mg/dL) were enrolled. The MCQ GFRs, corresponding to before and 48 hours post CAG and/or PCI were calculated using the SCr as a previously described protocol. CIN was defined as a 25% elevation in the SCr or an absolute increase of 0.5 mg/dL (44 micromole /L). RESULTS: Overall, CIN occurred in 14 (13.1%) patients. CIN developed in 4 (57.1%) patients who had an estimated MCQ GFR less than 60 mL/min/1.73 m2 and in 10 (10%) patients who had a GFR over 60 mL/min/1.73 m2 (p=0.005). On univariate analysis, CIN was associated with the baseline MCQ GFR (p=0.001), the C-reactive protein (CRP) level (p=0.001), the volume of contrast agent (p=0.005), the left ventricular ejection fraction (p=0.001) and the low density lipoprotein cholesterol level (p=0.030). On multivariate analysis, a baseline MCQ GFR < or =60 mL/min/1.73 m2 [odds ratio (OR)=2.0, p=0.001], the volume of contrast agent > or =250 mL (OR 17.1, p=0.002), a CRP level > or =0.5 mg/dL (OR 4.7, p=0.037) and a left ventricular ejection fraction < or =40% (OR 1.7, p=0.020) were the independent risk factors for CIN. CONCLUSION: The pre-coronary angiography MCQ GFR is a useful predictor for the development of CIN. Strong preventive strategies are needed to avoid developing CIN in these high-risk patients.
