The Efficacy of the Cystatin C Based Glomerular Filtration Rate in the Estimation of Safe Contrast Media Volume
Korean Circulation Journal
;
: 622-627, 2013.
Artigo
em Inglês
| WPRIM
| ID: wpr-85589
ABSTRACT
BACKGROUND AND OBJECTIVES:
The risk of contrast-induced nephropathy (CIN) is significantly influenced by baseline renal function and the amount of contrast media (CM). We evaluated the usefulness of the cystatin C (CyC) based estimated glomerular filtration rate (eGFR(CyC)) in the prediction of CIN and to determine the safe CM dosage. SUBJECTS ANDMETHODS:
We prospectively enrolled a total of 723 patients who received percutaneous coronary intervention (PCI) and investigated the clinical factors associated with the development of CIN. Renal function was calculated as eGFR(CyC) and a modified diet in the renal disease (MDRD) equation, respectively. Systemic exposure of CM was calculated as CM volume to eGFR ratio. We conducted a regression analysis to evaluate the predictive role of CM volume to eGFR(CyC) for the risk of CIN.RESULTS:
The incidence of CIN was 4.0% (29/723). The patients with CIN had a lower hemoglobin level, decreased renal function, and a higher CyC value, and had greater CM exposure. Through multivariate regression analyses, hemoglobin {odds ratio (OR) 0.743, p=0.032}, CM volume/eGFR(CyC) (OR 1.697, p=0.006) and CM volume/MDRD (OR 2.275, p<0.001) were found to be independent predictors for CIN. In the receiver operating characteristic curve analysis, fair discrimination for CIN was found at a CM volume/eGFR(CyC) level of 4.493 (C-statics=0.814), and at this value, the sensitivity and specificity were 79.3% and 80.0%, respectively.CONCLUSION:
Both the CM volume/MDRD and CM volume/eGFR(CyC) method would be simple, useful indicators for determining the safe CM-dose based on eGFR value before PCI. However, there was no significantly different predictive value between creatinine and CyC based GFR estimations.
Texto completo:
DisponíveL
Índice:
WPRIM (Pacífico Ocidental)
Assunto principal:
Hemoglobinas
/
Incidência
/
Estudos Prospectivos
/
Curva ROC
/
Sensibilidade e Especificidade
/
Meios de Contraste
/
Creatinina
/
Dieta
/
Discriminação Psicológica
/
Cistatina C
Tipo de estudo:
Estudo diagnóstico
/
Estudo de incidência
/
Estudo observacional
/
Estudo prognóstico
Limite:
Humanos
Idioma:
Inglês
Revista:
Korean Circulation Journal
Ano de publicação:
2013
Tipo de documento:
Artigo
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