Volume-to-creatinine clearance ratio: a predictor for contrast-induced nephropathy in chronic kidney disease after primary percutaneous coronary intervention
JIAN Chun-yan
LIU Yong
TAN Ning
WU Keng
ZHOU Ying-ling
CHEN Ji-yan
CHEN Yu-yi
QIN Xue-qing
CHEN Li-lin
MAI Guo-hui
摘要：Background The volume of contrast media to the creatinine clearance (V/CrCl) ratio has been shown to correlate with the contrast-induced nephropathy (CIN).The chronic kidney disease (CKD) patients would be more likely to develop CIN after primary percutaneous coronary intervention (PCI).Objective To determine a relatively safe V/CrCl cutoff value to avoid CIN in CKD patients undergoing primary PCI. Methods We enrolled a total of 114 patients with CKD and calculated V/CrCl. Receiver-operator characteristic methods were used to identify the optimal sensitivity and specificity for the observed range of V/CrCl for CIN. We used multivariable logistic regression to assess the predictive value of V/CrCl for the risk of CIN in CKD patients. Results Overall,there were 24 cases (21％) of CIN. The baseline mean and median V/CrCl values were significantly greater among patients with CIN (mean 5.08 ± 2.01,median 4.81,and interquartile range 3.53-6.33) than among those without CIN (mean 3.35 ± 1.48,median 3.12,and interquartile range 2.27-4.14,P ＜ 0.001).The receiveroperator characteristic curve analysis indicated that a V/CrCl ratio of 3.62 was a fair discriminator for CIN (Cstatistic of 0.75) in CKD patients. After adjusting for other known predictors of CIN,a V/CrCl ratio＞3.62remained significantly associated with CIN in CKD patients(odds ratio 8.46,95％ confidence interval 2.37-30.19,P ＜ 0.001). Conclusions AV/CrCl ratio＞3.62 is a simple,useful indicator for determining the safe contrast medium dose based on the pre-PCI CrCl values in CKDs.[S Chin J Cardiol 2011; 12(3):147-155]
机标关键词：
分类号：R541.4(心脏、血管（循环系）疾病)R692(泌尿科学（泌尿生殖系疾病）)
论文发表日期：2011-07-02
在线出版日期：2025-08-15（本平台首次上网日期，不代表文献的发表时间）
英文信息