Abstract:

Objective To observe effects of nonionic contrast medium on renal functions of patients undergoing coronary angiography. Methods A total of 556 inpatients (342 males and 214 females) who had undergone coronary angiography with nonionic contrast medium in Department of Cardiology, Shanghai Chest Hospital, Shanghai Jiaotong University, from September 2009 to February 2010 were selected. The series of renal function indexes of blood and urine were measured and compared in all patients before and after the angiography. Contrast-induced nephropathy (CIN) was defined as the variation of the absolute value of serum creatinine (Scr) over 44.2 μmol/L or with a rise of 25% than basis. Further evaluation should be needed to screen sensitive markers of CIN in those patients. Results In renal function indexes of blood, there were significant differences of concentrations of Scr, blood urine nitrogen (BUN), uric acid (UA), and retinal-binding protein (RBP) before and after angiography except for cystain C (Cys C) (P<0.05 or P<0.01). In renal function indexes of urine, there was significant difference of concentrations of α1-microglobulin (α1-MG) before and after angiography (P<0.01). Thirty-nine patients (18 males and 21 females) accorded with the diagnostic criteria of CIN and the incidence was 7.01%. The variation of α1-MG was the most obvious one with a rise of (39.77±16.75)%. The level of Ccr was still within normal limits (P>0.05), but the variation of eGFR was significant [(118.88±38.03) mL·min^-1·1.73 m^-2 vs (88.14±28.18) mL·min^-1·1.73 m^-2 in males, (107.69±38.65) mL·min^-1·1.73 m^-2 vs (77.40±30.71) mL·min^-1·1.73 m^-2 in females](P<0.01). Compared to CIN group, the mean dosage of contrast medium was significantly different in non-CIN group [(225.34±16.58) mL vs (201.56±13.27) mL](P<0.01). The Logistic multivariate regression analysis showed that the factors causing CIN were hypertension, diabetes mellitus, chronic renal insufficiency, and the mean dosage of contrast medium. Conclusion The variations of these indexes of CIN patients before and after angiography were related to the injection of nonionic contrast medium. The α1-MG was an early sensitive marker of CIN.

Key words: contrast medium, contrast-induced nephropathy, coronary artery disease, coronary arteriongraphy