الفهرس | Only 14 pages are availabe for public view |
Abstract Contrast induced nephropathy is a potentially avoidable complication caused during procedures involving the use of radiographic contrast media, All subjects, especially at high risk should be subjected to available preventive protocols prior to and after such procedures. The current study included 30 patients presented to the cath lab of Ain Shams university hospitals and the National Heart Institute with chronic total occlusion (CTO) for PCI. The current study was aiming to determine the incidence and predictors of contrast induced nephropathy (CIN) in patients undergoing PCI for their CTO. All the patients were subjected to full history taking with special emphasis on the known predisposing factors for CIN, clinical examination and serum creatinine was measured at baseline before PCI and after it by 48 hours, cockroft- gault formula was used to assess Cr.Cl. The study population was divided into two groups, the first in whom CIN had occurred while the second in whom CIN had not occurred. The current study found that CIN 0.5 (rise of SCr more than 0.5 mg/dl from the baseline value 48hr postprocedural) occurred in 2 patients only (6.7%) while CIN 25% (rise of SCr more than 25% from the baseline value 48 hr postprocedural) occurred in 6 patients (20%). and no one required hemodialysis. In the current study, there was no significant group differences regarding sex, incidence of diabetes mellitus, the type and amount of the contrast, but there was statistically significant difference between both groups regarding the age distribution of the patients, Chronic kidney disease, Congestive heart failure and hypotension. It was concluded from the current study that those with chronic kidney disease had about 3 times more risk for developing CIN 25% than others. Percutaneous treatment of CTO should not be discouraged by the fear of contrast induced nephropathy, despite the administration of moderate to large volumes of contrast medium. |