Analysis Of Factors Of Contrast Induced Nephropathy On Peripheral Angiopathy After Interventional Diagnosis And Treatment

Objective To investigate the incidence of contrast induced nephropathy（CIN）on peripheral angiopathy after interventional diagnosis and treatment, and toanalyze the influential factors for the incidence of CIN.Methods73patients of peripheral angiopathy, including50cases of arterydisease,23cases of venous disease. Then all patients used the contrast agent byintravascular injection, and the standard judgment of CIN was the absolute value ofthe level of serum creatinine increased44.2umol/L (0.5mg/dl) or relative valueincreased25%after48~72hours. Comparing of the two groups before and aftercontrast examination of renal function used repeated measures. Univariate analysisused X2test or Fisher′s exact test, and regression analysis used Binary Logistic.Result5cases of73patients experienced CIN，and the overall incidence was6.85%． The results of renal comparison between before and after contrastexamination were the level of serum BUN (F=23.945, P=0.008)、SCr (F=18.448,P=0.013), Cys-C (F=23.86, P=0.008)、UA (F=31.451, P=0.005)、A1M (F=21.561,P=0.010)、BMG (F=8.912, P=0.041) in CIN group increasing significantly，the levelof serum CO2(F=2.178, P=0.214) was no significant change. The level of serum A1M(F=4.735, P=0.033) was increased in non CIN group. The level of serum Cys-C(F=7.905, P=0.006)、A1M (F=9.102, P=0.004)、BMG (F=6.770, P=0.011) increasedin73patients who used contrast agent. Univariate analysis revealed that the age ofthe patients (X2=4.898, P=0.027)、the dosage of contrast agent (Fisher′s exact test,P=0.001)、the level of serum creatinine (Fisher′s exact test, P=0.003)、Cystatin-C (Fisher′s exact test, P=0.037)、α1-microglobulin (Fisher′s exact probability method,P=0.005)、 β2-microglobulin (Fisher′s exact test, P=0.022) before using contrastagent、chronic renal insufficiency before using contrast agent(Fisher′s exact test,P=0.001)、 cardiac dysfunction before using contrast agent(Fisher′s exact test,P=0.037)、taking ACEI medication (Fisher′s exact test, P=0.022) and nonsteroidalanti-inflammatory drugs (Fisher′s exact test, P=0.017) before using contrast agentwere the important influence factors of CIN. Binary Logistic regression analysis（αentry=0.10，αremoval=0.15）showed that the dosage of contrast agent (Wald=6.436,P=0.011) and combined chronic renal insufficiency(Wald=6.436, P=0.011) beforeusing contrast agent were associated with CIN.Conclusion In this study, the incidence of CIN was6.85%, the level of serumCO2in CIN were the least sensitive. The level of serum Cys-C、A1M、BMG canreflect the change of renal function earlier in73patients after using contrast agent.The dosage of contrast agent above150ml and combined chronic renal insufficiencybefore using of contrast agent were the risk factors for CIN.