Contrast Induced Nephropathy- A Single Centre Observational Study

Abstract

Background: CIN is an important cause of morbidity and mortality post cardiac procedures. Renal derangement and diabetes being the most important risk factors. Multifactorial causation of the disorder led us to study the risk factors associated with CIN. Methods: All patients who underwent cardiac procedures between March 2019 and March 2020 were screened for CIN and included in the study. Out of the 3192 patients screened 99 patients were diagnosed with CIN. Parameters such as diabetes mellitus, hypertension, CKD, anemia, duration of hospital stay, cardiogenic shock, number of stents, amount and type of contrast, Ejection Fraction, creatinine clearance before and after the procedure, concomitant nephrotoxic drugs were also recorded.  Results: Ninety-nine patients developed CIN amounting to 3% of the total procedures, 11% expired, 18% required dialysis, average creatinine clearance before the procedure was 53.15 ml/min/1.73 m2 and post procedure it was 29.16 ml/min/1.73 m2, 51.5% of cases had creatinine clearance prior to procedure <60 ml/min/1.73 m2, 60.6% were diabetic, 81.8% were hypertensive, 30.3% were anaemic, 15% had heart failure, 33% required ventilatory assistance, average haemoglobin level was 11.83 mg/dl, 33% received iso-osmolar contrast and 45% had EF of 35% or less. Conclusions: CIN has a multifactorial causation most common being prior renal derangement and diabetes mellitus. This is one of a kind study in this part of country among cardiac patients. Newer biomarkers of kidney injury could also be studied in future.