Risk factors for contrast-related acute kidney injury according to risk, injury, failure, loss, and end-stage criteria in patients with coronary interventions

Although a series of risk factors for contrast-induced nephropathy are known, data on significance of some of the risk factors such as age, sex, hypercholesterolemia, hyperuricemia, and dose of contrast medium are inconsistent. Our aim was to identify risk factors for contrast-related acute kidney injury [AKI]. In this prospective study, 290 consecutive patients with a serum creatinine level lower than 3 mg/dL undergoing percutaneous angiography were analyzed. Contrast-related AKI was evaluated using the risk, injury, failure, loss, and end-stage [RIFLE] criteria, and its correlation with clinical and laboratory data of the patients was analyzed. Contrast-related AKI was found in 15.5% of the patients, with a maximum RIFLE category [risk in 13.8%, injury in 1.4%, and failure in 0.3%]. Serum creatinine level, contrast volume, safe contrast volume factor, diabetes mellitus, and dehydration were significantly associated with contrast-related AKI. Age, sex, and serum uric acid level did not differ significantly between those with and without contrast-related AKI. Multiple logistic regression analysis disclosed diabetes mellitus to be the strongest predictor for being at risk of contrast-related AKI [odds ratio, 5.1; 95% confidence interval, 1.9 to 11.0; P=.001], followed by hypercholesterolemia [odds ratio, 4.6; 95% confidence interval, 1.1 to 8.3; P=.03], and an estimated glomerular filtration rate lower than 90 mL/min/1.73 m[2] [odds ratio, 3.0; 95% confidence interval, 1.8 to 5.7; P=.003]. Our results indicate that diabetes mellitus, hypercholesterolemia, and underlying chronic kidney disease are the major factors of contrast-related AKI

Dialysis adequacy and kidney disease outcomes quality initiative goals achievement in an Iranian hemodialysis population

We conducted this study to measure hemodialysis adequacy and determine to what extent some Kidney Disease Outcomes Quality Initiative [KDOQI] goals are achieved in our patients. In a cross-sectional study in Pars province, Iran, we assessed 632 patients on hemodialysis in 15 dialysis centers. The Kt/V was calculated, and data on serum levels of albumin, cholesterol, and triglyceride, hemoglobin level, blood pressure, body weight, and body mass index were collected. The values were compared with the KDOQI recommended target values. The mean age of the patients was 54.36 +/- 16.34 years. The mean Kt/V was 0.97 +/- 0.42, which was significantly higher in those who received 3 dialysis sessions per week than those on 2 dialysis sessions per week [P = .03]. Only 32.1% of all patients achieved the Kt/V goal. Seventy-four percent of the patients had a serum albumin equal or greater than 4 g/dL. Hemoglobin levels were between 4.6 g/dL and 16.8 g/dL, and half of the patients had attainment of the hemoglobin target. Cholesterol target was reached in 40% of patients. Only 43 patients [6.8%] attained all targets recommended by the KDOQI guidelines. The target values, except for serum albumin, were not reached in our patients. We conclude that it is necessary to provide essential equipment of dialysis centers such as dialysis machine and trained staffs, and also to raise awareness of KDOQI goals among patients and physicians