PCI Postoperative Contrast Medium Nephropathy Clinical Research

The purpose of this prospective observational study of 300 patients were treated with non-ionic contrast medium hypotonic or isotonic of Iohexol contrast medium iodixanol in patients for coronary angiography changes in renal function, renal function and effect various risk factors multiple stepwise regression analysis to explore the contrast agent nephropathy related factors and outcome; understand the permeability of non-ionic contrast medium or isotonic contrast medium iodixanol of coronary intervention on renal function in patients undergoing the impact of contrast induced nephropathy inquiry (CIN) and the incidence of risk factors.Methods All subjects chosen path of radial artery, according to Judkin's method,7F catheter for coronary angiography. Angiography the same day, respectively, angiography 1 day after the first two days taking the early morning fasting blood 7ml, which 3ml for the determination of blood urea nitrogen (BUN), Scr and electrolyte, the experimental results are mean±standard deviation and apply SPSS13.0 statistics package for statistical analysis, the main statistical indicators for normality and homogeneity of variance test, data, analysis of variance with repeated measurements on the risk factors for multiple stepwise regression analysis, using bilateral P<0.05 as statistically significant.Results Among 300 patients,172 cases of men,128 women, mean age 62.57±12.4 years (16 to 93 years), of which> 65 are 152, accounting for 50.67% (152/300),69 diabetic patients,23.00%(69/300), in which renal insufficiency with diabetes mellitus in; 7 cases (2.33% of total number of cases), hypertension 228, accounting for 76.00 (228/300), hyperlipidemia in 65 cases (21.67%) hyperuricemia in 42 patients (14.%), high dose of contrast agent in 79 cases (25.1%),26 cases of cardiac function grade 3-4 (8.67%), anemia 2 (0.67%), proteinuria 12 (4.00%) older, female, heart failure, proteinuria, preoperative use of diuretics, renal artery stenosis and the use of isotonic contrast agents induced a high proportion of CIN is an important factor. The mean preoperative fluid volume were less closely associated with the occurrence of CIN; diabetes, renal dysfunction may increase the risk of CIN; CIN group the incidence of major adverse events (recurrent angina than outside) than non-CIN group; CIN patients hospital stay than non-CIN group; CIN group of hospital mortality was significantly higher than non-CIN group, the difference was statisticallysignificant (P<0.01). Univariate statistical analysis on the possible risk factors associated with CIN into Logistic regression analysis revealed that the basis of serum creatinine, chronic renal failure, chronic congestive heart failure combined CKD, renal artery stenosis, lack of effective circulating volume, multi-branch coronary artery disease, acute myocardial infarction, hypoalbuminemia, anemia associated with CIN, P all<0.05, Table 5; and older (> 65 years), hypertension, DM and no correlation between the incidence of CIN.Conclusion. In this study, CIN incidence rate of 14%(42/300); older, female, heart failure, proteinuria, preoperative use of diuretics, renal artery stenosis and the use of a high proportion of isotonic contrast agent is induced CIN important factors. The mean preoperative fluid volume were less closely associated with the occurrence of CIN; diabetes, renal dysfunction may increase the risk of CIN; CIN group the incidence of major adverse events (recurrent angina than outside) than non-CIN group; CIN patients hospital stay than non-CIN group; CIN group of hospital mortality was significantly higher than non-CIN group, the difference was statistically significant (P＜0.01). Univariate statistical analysis on the possible risk factors associated with CIN into Logistic regression analysis revealed that the basis of serum creatinine, chronic renal failure, chronic congestive heart failure combined CKD, renal artery stenosis, lack of effective circulating volume, multi-branch coronary artery disease, acute myocardial infarction, hypoalbuminemia, anemia associated with CIN, hypertension, DM and the occurrence of CIN was no correlation. Univariate statistical analysis on the possible risk factors associated with CIN into Logistic regression analysis revealed that the basis of serum creatinine, chronic renal failure, chronic congestive heart failure combined CKD, renal artery stenosis, lack of effective circulating volume, multi-branch coronary artery disease, acute myocardial infarction, hypoalbuminemia, anemia associated with CIN, while hypertension, DM and no correlation between the occurrence of CIN.